The Impact of Condom Distribution Programs on Teen Chlamydia and Gonorrhea Rates in Philadelphia, 2010–2014

Background:  In 2010, rates of chlamydia and gonorrhea among teens (aged 15–19 years) living in Philadelphia were significantly higher than national rates for the same age group (3.5 and 3.0 times, respectively). Condom distribution has been identified as an effective intervention that reduces the incidence of sexually transmitted infections (STIs). In 2011, in response to the alarming 2010 chlamydia and gonorrhea rates, the Philadelphia Department of Public Health (PDPH) initiated a free condom mailing service targeting teens. In 2013, PDPH installed condom dispensers in all public high schools. These programs complemented condom-distribution efforts taking place through the PDPH high school chlamydia/gonorrhea (CT/GC) education and screening program.

Methods:  Using ArcGIS software, teen CT/GC rates (# of cases/1,000 teens) were mapped for the 47 Philadelphia zip codes served by PDPH for the years 2010–2014 (154,985 total cases). Condom-distribution rates (# of condoms/1,000 teens) were mapped by zip code for 2011–2014 and cumulatively. The overall percentage change in the chlamydia and gonorrhea rates between 2010 and 2014 was calculated for each zip code and mapped. Visual comparison of CT/GC and condom-distribution rate maps enabled trend identification.

Results: Philadelphia saw a 26.5% (24 per 1,000) decrease in teen CT/GC rates between 2010 and 2014. Percentage changes in CT/GC rates within zip codes ranged from 55.8% (24 per 1,000) to 83.3% (12 per 1,000). A total of 445,400 condoms were distributed during the 5-year period. Zip codes that had high condom-distribution rates demonstrated the greatest decrease in CT/GC rates. Similarly, zip codes with low condom-distribution rates showed lesser decreases in teen CT/GC rates.

Conclusions: This project demonstrates the effectiveness of condom-distribution programs in reducing STI rates in vulnerable populations. The maps also helped identify Philadelphia zip codes where more intervention is needed to reduce teen chlamydia and gonorrhea.