Access to Condom through Condom Vending Machine in Thailand: Development and Community Participation

Abstract

At present, trend of unsafe casual sex, particularly among youth, had increased, causing an increasing trend of sexually transmitted infections (STIs) cases and risk to HIV infections. Accessibility to condom was limited due to high price of condom and shyness to buy. Department of Disease Control launched two projects, in which parts of the projects were to develop system to increase condom accessibility through condom vending machine (CVM). The projects was first conducted nationwide in 2004. The objectives of this study were to gather data and synthesize knowledge of such development, to document projects' outputs and outcomes and to recommend further development. Data were collected from provincial projects' reports, site visits and meetings, survey of satisfaction among customers, survey among provincial health staff and CVM producers or importers, and reviews of related documents. It was found that the development was conducted in preparation, implementation and expansion phases. The results, divided into 4 aspects as follows: 1. Expansion of CVM. There were limited numbers of CVMs available before 2004. However, up to 2007, 7,967 CVMs were installed directly or indirectly as lead by the strategy developed by the projects, supported by various organizations. Price of condoms selling through CVMs was 5-10 Baht per 2-3 pieces. 2. Development of the machine model. Initial model was imported, plastic-made, and used with non-electricity mechanism. Several models have been developed later. Most were produced locally, made from metal, able to contain higher number of condom boxes (up to 96 boxes/machine), with choices of electricity and non-electricity used mechanism. 3. Development of CVM management. There were 4 managerial models observed from the projects development. CVM management can be performed 1) health staff, 2) community, 3) NGOs and 4) health staff and community. 4. Monitoring and evaluation. Evaluation showed median condoms sale were 46.5 and 31.0 pieces/machine-month (m-m) in urban, and 40.0 and 32.5 pieces/m-m in rural in 2005 and 2006 respectively. Suitable installment places were hotel, dormitory, hospital, health center, department store and cinema. 89.8% of customers reported satisfied with CVM service. Obstacles found were misplacement of CVMs, coins stolen, unsatisfied maintenance service and CVM management problems. This study revealed a successful promotion of condom accessibility through CVM leading to higher rate of condom used and began-to-decline trend of STIs. Further development should gear towards ownership of local administrations and community participation to sustain CVM management, with closed monitoring and evaluation.