Examining Geographic Proximity As a Means to Increase Access to Free Condoms Among Teenagers 15-19 Years Old in Areas with High Rates of STDs

Background:  In 2014, Rhode Island experienced a ten-year peak in the number of cases of STDs reported to the Department of Health, the majority occurring in young people ages 15-24. The Center for HIV, Hepatitis, STDs, and TB receives dedicated funding for the distribution of condoms to high-risk populations. The Center currently distributes over 250,000 condoms annually in over 50 different locations. However, most dispensers are located in venues that are not frequented by teenagers. This analysis aims to identify geographically-optimal locations for condom dispensers to improve accessibility to teenagers.

Methods:  Chlamydia counts from 2012-2014 in people ages 15-19 were mapped to determine areas of highest morbidity in Rhode Island. Layers were also constructed to show the distribution of teen pregnancy, race/ethnicity, and urban housing.  Condom dispenser locations and high schools (public, private, and charter) were mapped in the high-morbidity areas.  Half-mile, walkable buffer zones were then applied to the geospatial analysis to identify potential dispenser locations that could be accessed by teens.

Results:  A geospatial correlation was found between areas with a large burden of chlamydia and other factors typically associated with populations at risk for STDs, such as race and ethnicity, teen pregnancy rates, and socioeconomic status.  Free condom dispensers, however, were not located in these areas.  Buffer zones of a one-half mile radius from the nearest high schools identify potential locations where dispensers can be strategically positioned to promote access to free condoms among teens in these areas.

Conclusions:  Condom dispensers available through the Rhode Island condom distribution program are not located in areas where teenagers, who are disproportionately impacted by STDs, can easily access them.  These findings show an opportunity for improvement in targeting vulnerable teen populations with the goal of reducing STD and HIV burden in Rhode Island.