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<p>Like many developing countries, Pakistan has a high prevalence of sexually transmitted infections (STI) and a high fertility rate. Both impose large social costs, predominantly on young women. Condoms can help address both challenges, yet uptake remains low in Pakistan. The objective of our study was to test the hypothesis that the interaction needed to buy condoms in a public setting—such as a shop—induces anxiety, thus holding back demand. To do this, we ran a randomized controlled trial (n = 1128) lasting 10&#xa0;months. The treatment conditions attempted to reduce anxiety by providing an anonymized, phone-based and free-of-cost door-step condom delivery service. Couples in the control condition received shop-redeemable coupons for free condoms, approximating business-as-usual condom buying. We document two major results. First, we find that shop-redeemable coupons were more popular than either of the home delivery options. This suggests that either our shop-based coupon inadvertently reduced social anxiety by simplifying the interaction at the shop or, we were not truly able to overcome anxiety with home delivery. Second, we found that couples with young women responded positively to the discreet home delivery option. Our findings suggest that the bourgeoning global low-cost home-delivery infrastructure is a useful tool that policymakers can leverage for getting condoms to sexually active couples, especially couples with young women who are most at risk of acquiring STIs and having unintended pregnancies.</p>

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Discreet home delivery of condoms as a feasible approach to meeting young women’s contraceptive demand

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月10日

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  • Agha Ali Akram,
  • Mahrukh Khan,
  • Faisal Bari,
  • Asifa Khanam

摘要

Like many developing countries, Pakistan has a high prevalence of sexually transmitted infections (STI) and a high fertility rate. Both impose large social costs, predominantly on young women. Condoms can help address both challenges, yet uptake remains low in Pakistan. The objective of our study was to test the hypothesis that the interaction needed to buy condoms in a public setting—such as a shop—induces anxiety, thus holding back demand. To do this, we ran a randomized controlled trial (n = 1128) lasting 10 months. The treatment conditions attempted to reduce anxiety by providing an anonymized, phone-based and free-of-cost door-step condom delivery service. Couples in the control condition received shop-redeemable coupons for free condoms, approximating business-as-usual condom buying. We document two major results. First, we find that shop-redeemable coupons were more popular than either of the home delivery options. This suggests that either our shop-based coupon inadvertently reduced social anxiety by simplifying the interaction at the shop or, we were not truly able to overcome anxiety with home delivery. Second, we found that couples with young women responded positively to the discreet home delivery option. Our findings suggest that the bourgeoning global low-cost home-delivery infrastructure is a useful tool that policymakers can leverage for getting condoms to sexually active couples, especially couples with young women who are most at risk of acquiring STIs and having unintended pregnancies.