Understanding constraints to adolescent condom procurement: the case of urban Botswana.

Even when condoms are widely available and affordable, adolescents may be reluctant to obtain them. Hence, programme managers need to understand what determines youths' perceptions of access to condoms. This paper analyzes focus group and survey data on condom access conducted among male and female adolescents in urban Botswana. Although a majority of sexually experienced adolescents have purchased condoms from retail outlets, only about 50% have obtained condoms from health facilities, even though the latter distribute free condoms. This study shows that many adolescents perceive that access to condoms is more difficult from public sector outlets than for private sector outlets, because the public sector providers tend to question the adolescents' behaviour while the latter do not. To bypass this problem, males tend to obtain condoms from friends. However, females are reluctant to ask their friends for condoms because they fear that their friends may gossip about them. The results of this study indicate that adolescents' access to condoms can be improved by interventions that improve the quality of interaction between public sector providers and adolescents, destigmatize condom use, expand private sector condom distribution, and that use peer sales agents and educators.