Journal of Family Medicine and Community Health

Costly Condoms or Costly Risks

Research Article | Open Access Volume 4 | Issue 8 |

  • 1. Department of Pediatrics and Adolescent Medicine, Albany Medical Center Hospital, USA
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Corresponding Authors
David F. DeMase, Albany Medical Center Hospital, Department of Pediatrics and Adolescent Medicine, MC-88 (Attn: Dr. Martha Lepow), 47 New Scotland Avenue, Albany, NY, 12208; Tel: 518-860-2403; Fax: 518262-5301 (Attn: David DeMase and Dr. Martha Lepow).

Male latex condoms (MLCs) serve as prevention and reduce the transmission of sexually transmitted infections (STIs). Limited access and availability, however, can lead to underutilization. To evaluate cost and the current purchase barriers in the commercial setting, I visited 62 national chain pharmacies (NCPs), 76 independent pharmacies (IPs), 58 grocery stores (GSs), and 146 convenience stores (CSs) throughout jurisdictions impacted by STIs. Additionally, since many recipients of governmental health insurance have access to condom coverage, I examined the condom coverage of 25 private health insurance companies (HICs). Overall, it was discovered that NCPs marketed MLCs at the highest cost, while IPs and GSs were similarly priced and marketed MLCs at the lowest price. The average cost of MLCs was lower in high poverty jurisdictions. Also, access to MLCs in various outlets was often impacted by restricted commercial settings. Finally, HICs commonly declared MLCs over-the-counter products. Some also claimed MLCs lack medical importance. For prevention and the benefit of society, an improvement in access to MLCs is in demand. 


•    Male latex condom
•    Prevention
•    Sexually-transmitted infection
•    HIV 


MLCs: Male Latex Condoms; PrEP: Pre-Exposure Prophylaxis; HIV: Human Immunodeficiency Virus; STI: Sexually-Transmitted Infection; NCP: National Chain Pharmacy; IP: Independent Pharmacy; CS: Convenience Store; GS: Grocery Store; OC: Outlet Category; OTC: Over-the-Counter; BTC: Behind the Counter; NYC: New York City; NYS: New York State; HIC: Health Insurance Company


DeMase DF (2017) Costly Condoms or Costly Risks. J Family Med Community Health 4(8): 1137.


In New York State (NYS), the human immunodeficiency virus (HIV) has been a challenging epidemic. Current statistics indicate that approximately 123,000 residents within the state are HIV-infected, and nearly 8% of them were unaware of their positive serostatus [1]. An estimated 3,000 new infections appear annually [1,2].

To reduce the number of infections, save lives, provide treatment, and improve the health status of residents, Governor Andrew Cuomo has initiated the Ending the AIDS Epidemic Program. Reducing the annual number of new HIV infections to 750 by the end of the year 2020 is the overall goal [2]. To accomplish this goal, a three-point plan has been devised and accomplishes the following:

  1. “Identifies persons with HIV who remain undiagnosed and link them to health care [2].”
  2. “Links and retains persons diagnosed with HIV in health care to maximize viral suppression so they remain healthy and prevent further transmission [2].”
  3. “Facilitates access to PreExposure Prophylaxis (PrEP) for high-risk persons to keep them HIV-negative [2].”

 In addition to PrEP, male latex condoms (MLCs) serve as prevention. Hence, they should allow the governor’s goal to be accomplished. There are, however, a multiplicity of factors that contribute to the underuse of condoms. While blame for nonuse is frequently placed on religion and morality, lifestyles such as sex work and substance abuse are common reasons why condoms fail to be used consistently [3]. Female oral contraceptives and issues ranging from discomfort to a lack of knowledge are responsible for the underutilization of condoms [3-5]. Furthermore, relationship concerns, especially commitment, have served as barriers [3-5].

Social pressures related to economics also explain why several sexually-active persons disregard condoms [3-5]. Poverty-stricken African American men have admitted to cost being a barrier [4,5]. To assist individuals in gaining access more easily, state health departments, Planned Parenthood, medical clinics, and gay and lesbian support centers frequently dispense condoms at no cost. Moreover, Medicaid plans in NYS [6] and other states provide condom coverage, often with a prescription.

Because condoms serve as STI-reducing devices, it is obvious that all sexually-active persons benefit from their use. Furthermore, condoms are the male contraceptive. Thus, coverage by a health insurance company (HIC), governmental or non-governmental, would serve society and be comparable to the Affordable Care Act’s mandatory coverage of female contraceptives. Female contraceptives include not only oral birth control, but also female condoms. Any reason a HIC may refuse to provide condom coverage to males should be identified. To obtain these data, the policies of different HICs were examined.

Finally, after a general observation that variation with condom retail existed throughout different outlets within a neighborhood of Albany, New York, it was postulated that such variations could interfere with condom access and therefore the state’s Ending the AIDS Epidemic Program. In 2010, Rizkalla et al., studied the retail access and availability of MLCs [7]. Due to the time lapse, and in effort to identify current impediments, a similar study was conducted. While the methods for this study had some similarities, including a jurisdiction and the classes of commercial settings visited, the study was broader and included additional high-risk territories as Rizkalla et al., suggested for future studies. The cost of MLCs was incorporated into this study as well, since cost is a known barrier to condom use and to my knowledge, has not been studied in detail. In summary, identifying factors that contribute to the underutilization MLCs was the objective of this study.


Sale of Condoms

Participating Entities: National chain pharmacies (NCPs), independent pharmacies (IPs), grocery stores (GSs), and convenience stores (CSs) throughout Albany County of NYS and New York City’s boroughs of Manhattan and the Bronx were visited to study the commercial access of MLCs. These geographic locations were selected, because STIs have significantly impacted the residents over time. The CSs included bodegas, corner stores, delis, and mini marts, some of which were affiliated with gas stations.

Due to the significant social differences between uptown Manhattan and midtown-downtown Manhattan, these jurisdictions were independently analyzed. Uptown Manhattan included all neighborhoods above 59th Street. Midtown-downtown Manhattan included neighborhoods from 59th Street and below.

Measures: To study the commercial access and availability of MLCs, the general sale of the product was assessed. Concurrently, while the average cost of MLCs was studied, the methods by which outlets offered the items were examined as well.

Procedure: With the exception of the IPs of Albany County, each sample was randomly selected through an online search and computer randomization. Due to the scarcity of IPs in business within Albany County, random selection of this outlet category (OC) within this jurisdiction was not an option.

For approximately 10 days, over a time period of four months, MLCs were studied based on OC and geographical location. Prices were documented according to the quantity of MLCs sold within a box, OC, and geographical location. All types and brands of MLCs were included in the sample pools. No restrictions were placed on the number of boxes of MLCs that comprised the sample pools. Some outlets had a wider selection of MLCs than others. Furthermore, the same brands were frequently sold throughout all OCs. Because all condom-selling establishments visited sold boxes with a quantity of three condoms per box, and sometimes single condoms, this study focused on these quantities. The average was calculated according to cost per box within an OC and particular jurisdiction.

Finally, when the MLCs were sold under restricted settings, store clerks and/or managers were asked to provide the prices, as well as the reasons why the MLCs were sold under such conditions. Employees were also approached when MLCs could not be found. In this way, prices could be obtained or the conclusion that MLCs were not sold could be made.

Analysis Plan: Statistical analysis was by analysis of variance (ANOVA) with effects of geographic location, outlet type, and their interaction. Multiple comparisons were by Tukey’s HSD test (Minitab statistical software and Statistica statistical software). The dependent variable was cost per box.

The ANOVA included independent variables for a main effect of geographical location (with four levels: Albany, Bronx, Uptown Manhattan and Midtown-Downtown Manhattan), a main effect of outlet (with 4 levels: national chain pharmacies, independent pharmacies, grocery stores and convenience stores), and their interaction. A significant interaction indicates that the effect of location differs for each outlet type. All effects (location, outlet and their interaction) were statistically significant at the p<0.001 level. The significant interaction indicates that the effect of outlet type on price was different for the four locations.

The average costs were plotted. The overall average cost of a box of MLCs according to outlet category is presented in Figure 1. Figure 2 and Figure 3 present average cost according to outlets in particular geographical locations.

Health Insurance Coverage

Participating Entities: To study non-governmental health insurance condom coverage, 25 HICs throughout California, New York, Texas, Maryland, and Pennsylvania were contacted. These states are among the top ten states that have the greatest number of HIV diagnoses, according to the Center for Disease Control [8]. The identity of the HICs remained confidential.

Measures: To study health insurance coverage of MLCs, the policies and prescription formularies of different non-governmental HICs were examined. Reasons MLCs failed to be covered were investigated.

Procedure: Non-governmental HICs were contacted telephonically after being randomly selected through an online search and computer randomization. Employees, including managers, associated with the company’s Department of Sales, Department of Member Services, and/or Department of Claims and Benefits were questioned about the company’s policy of MLC coverage. Reasons for the lack of coverage were requested.

Analysis Plan: The fraction of non-governmental HICs providing MLC coverage was calculated. When coverage was not offered, reasons were identified and compared.



Per box of three: Without regard to geographical location, it was evident that NCPs were most costly at marketing MLCs. GSs were noted for marketing boxes of MLCs at the lowest average price.

However, as indicated by the 95% confidence intervals (CIs) in Figure 1, the prices of MLCs at IPs were essentially equivalent to those marketed at GSs. Furthermore, a marginal, yet statistically significant cost difference existed between the average cost of MLCs marketed at CSs and those at IPs and GSs. Figure 1 denotes this general cost pattern. As illustrated in Figure 2 and Figure 3, further analysis of these data present additional trends, particularly the geographical similarities and differences.

Figure 1 Average cost per box of male latex condoms among different outlets. Error bars indicate 95% confidence interval for the mean

Figure 1: Average cost per box of male latex condoms among different outlets. Error bars indicate 95% confidence interval for the mean


Throughout the primary jurisdictions, the general cost pattern was observed. MLCs were consistently most costly at NCPs. GSs frequently marketed the products at the lowest average cost, especially in Albany County and the Bronx. While IPs appeared to sell MLCs at the lowest average cost throughout Manhattan, Table 1 and the 95% CIs in Figure 2 demonstrate that the GSs in this jurisdiction priced MLCs similarly. With the exception of IPs, the average cost of MLCs at the OCs appeared to present no vast price differences throughout any of the primary jurisdictions. Overall, however, the Bronx appeared to be the primary jurisdiction that marketed MLCs at the lowest price. As particular regions within Manhattan were explored, cost distinctions continued to be observed more precisely.

As illustrated in Figure 3, the outlets located in the midtown-downtown neighborhoods of Manhattan were more costly than those located in the uptown neighborhoods. The average cost of MLCs marketed in midtown-downtown NCPs was approximately $7.08 per box and higher than those marketed uptown and in Albany County by no more than $0.61 per box (Table 1).

Likewise, the average cost for a box of MLCs sold at the CSs, GSs, and IPs of the midtown-downtown region ranged from $4.06 to $5.41. Hence, these outlets were 29-53% more costly than outlets of the same class located in the uptown jurisdiction, which ranged from $2.32 to $3.63 (Table 1 and Figure 3). In the Bronx, the average cost of MLCs at GSs and IPs was $2.59 and $2.74, respectively, and differed from those available throughout uptown Manhattan by no more than 15% (Table 1 and Figure 3).

As indicated by the ANOVA in Table 2, there was a significant effect on outlet type, F (3, 1581) =554.6, p<0.001. The effect on geographical location was also significant, F (3, 1581) =23.34, p<0.001. Furthermore, their interaction was significant, showing there was a difference between outlets in jurisdictions, F (9, 1581) =38.3, p<0.001.

Finally, as noted in Table 1, MLCs were more broadly priced at IPs and CSs. Likewise, the NYC outlets, especially those located in Manhattan, were more broadly priced than those located in Albany County.

Singles: Some of the CSs and IPs visited offered only single condoms, while some offered packaged ones in addition. Overall, it was observed throughout the Bronx that 72% (36/50) of CSs and approximately 17% (5/29) of the IPs visited provided single condoms. In Manhattan, single condoms were unavailable in the midtown-downtown CSs visited. In the uptown neighborhoods, however, approximately 61% (20/34) of CSs and 4% (1/24) of IPs visited offered single condoms. Likewise, 52% (16/31) of the CSs visited in Albany County, especially ones located in the more urbanized neighborhoods, sold single condoms. Neither NCPs nor GSs in any jurisdiction marketed single condoms.

Figure 2 Average cost per box of male latex condoms among different outlets in primary locations. Error bars indicate 95% confidence interval on the mean.

Figure 2: Average cost per box of male latex condoms among different outlets in primary locations. Error bars indicate 95% confidence interval on the mean.


Although single condoms were available at CSs and IPs, the expense at which they could be purchased differed among the two OCs. The majority of CSs throughout all regions routinely marketed single condoms for a price that ranged from $0.50 to $1.25 per condom. Larger-sized condoms were most costly. Concurrently, in NYC, the single condoms available at the IPs and a fraction of the CSs were cost-free and supplied by the Department of Health.

Commercial Access

NCPs throughout Albany County, the Bronx, and Manhattan frequently marketed MLCs from an open display. At most NCPs, the MLCs were placed in close proximity to the pharmacy, as well as in the “Family Planning” aisle. On occasion, however, NCPs in each of the jurisdictions visited did market MLCs in a restricted manner and from locked or simple alarmed settings.

Nearly every CS visited throughout the Bronx and Manhattan offered MLCs from behind the counter (BTC). Approximately 19% (6/31) of the CSs visited in Albany County, however, marketed MLCs from an open display.

The condom-selling IPs of Albany County consistently marketed MLCs from BTC. One IP visited (1/6) failed to sell condoms due to the majority of customers being senior citizens. The selling practices of IPs located in NYC, however, varied. Eighty-one percent (21/26) of all condom-selling IPs visited in the Bronx and approximately 40% (16/41) of those visited in Manhattan offered MLCs in a restricted manner and primarily from BTC. Furthermore, the midtown-downtown neighborhoods of Manhattan were less likely to sell MLCs from BTC than the uptown neighborhoods. While 94% (16/17) of the midtown-downtown IPs visited sold MLCs from an open display and in close proximity to the pharmacy, only 42% (10/24) of the uptown IPs visited marketed MLCs in the same way.

Figure 3 Average cost per box of male latex condoms among different outlets in the four locations sampled. Error bars indicate 95% confidence interval on the mean.

Figure 3: Average cost per box of male latex condoms among different outlets in the four locations sampled. Error bars indicate 95% confidence interval on the mean.


MLCs were marketed in all of the GSs visited in Albany County, primarily in the “Family Planning” aisle. They were not as accessible in the GSs of NYC, however. A significant access barrier pertained to general availability. Approximately 30% (6/20) of the GSs visited in the Bronx and 28% (8/28) of those visited in Manhattan failed to sell MLCs. In addition to theft, managers provided reasons that ranged from “pharmacies being up the street” to the product “never selling when it was available.”

In the GSs that did market MLCs, it was common for the product to be highly secured. At 50% (7/14) of the condom-selling GSs visited in the Bronx, 55% (11/20) of those visited in Manhattan, and 18% (2/11) of the GSs visited in Albany County, MLCs were available from a locked case located in close proximity to the cashiers. Similarly, 50% (7/14) of the condom-selling GSs visited in the Bronx, 45% (9/20) of those visited in Manhattan, and 18% (2/11) of the GSs visited in Albany County marketed MLCs from BTC. One company in Albany County consistently marketed condoms from behind the pharmacy, causing customers to be denied access after pharmacy hours.

Finally, in all jurisdictions, the primary reason given for MLCs being placed in restricted settings was the high theft nature of the product. The high crime rate of some locations also contributed to more secure selling practices.

Insurance and Condom Coverage

Twenty-three of the 25 non-governmental HICs contacted were willing to discuss their policies. All participating companies are similar, inasmuch as none insure MLCs.

The primary reason MLCs are excluded from the plans of coverage is that they are considered over-the-counter (OTC) products. Hence, they are ineligible for prescription. Three HICs in New York first placed blame on employers and did not identify MLCs as OTC products until being questioned about unemployed, financially-secure patients who are capable of purchasing health insurance plans independently.

Furthermore, a HIC in Texas emphasized that no state or federal mandate to cover the cost of MLCs has been enacted. Concurrently, at least one HIC in every state, and overall 26% (6/23) of HICs comprising the sample, claimed MLCs are not “medically necessary.” Upon being asked to define this term, responses included “vital to life,” “a benefit for life,” and “necessary to address medical conditions.” Additionally, in the process of describing “medically necessary,” multiple HICs routinely referred to the glucometer, an instrument used by persons with diabetes to assess glucose levels.

Table 1: Condom prices throughout different jurisdictions and outlets.

Jurisdiction Outlet No. outlets visited Sample size Average price per box (Avg ± SD) Price Range
Albany County NCPs   17 n=186 $6.47± 0.52 $4.99 - $7.39
NYC¹ NCPs   45 n=445 $6.87± 0.67 $5.49- $8.99
Bronx NCPs   16 n=160 $6.60± 0.52 $5.49- $7.99
Manhattan² NCPs   29 n=285 $7.02± 0.54 $5.49- $8.99
Manhattan³ NCPs   18 n=177 $7.08± 0.69 $5.49- $8.99
Manhattan4 NCPs   11 n=108 $6.90± 0.69 $5.49- $8.29
Albany County IPs    6 n=16 $4.54± 2.295 $1.56- $8.43
NYC¹ IPs   70 n=296 $2.93± 1.196 $1.29- $7.23
Bronx IPs   29 n=114 $2.74± 0.987 $1.49- $5.99
Manhattan² IPs   41 n=182 $3.05± 1.30 $1.29- $7.23
Manhattan³ IPs   17 n=76 $4.06± 1.34 $1.49- $7.23
Manhattan4 IPs   24 n=106 $2.32± 0.59 $1.29- $4.29
Albany County GSs   10 n=64 2.78± 0.30 $1.99- $3.19
NYC¹ GSs   48 n=104 2.80± 1.028 $1.49- $5.99
Bronx GSs   20 n=43 2.59± 0.829 $1.79- $5.99
Manhattan² GSs   28 n=61 2.95± 1.1310 $2.95- $5.99
Manhattan³ GSs   10 n=9 5.41± 0.5411 $5.41- $5.99
Manhattan4 GSs    18 n=52 2.53± 0.4612 $2.53- $3.35
Albany County CSs   38 n=121 $3.61± 0.67 $2.69- $5.39
NYC¹ CSs   108 n=362 $3.90± 1.1013 $1.58- $7.00
Bronx CSs    50 n=156 $3.23± 0.6014 $1.99- $5.00
Manhattan² CSs   58 n=206 $4.40± 1.15 $1.58- $7.00
Manhattan³ CSs   24 n=107 $5.10± 0.85 $4.00- $7.00
Manhattan4 CSs   34 n=99 $3.63±0.92 $1.58-$5.99

1 Includes the Bronx and Manhattan
2 Includes downtown, midtown, and uptown Manhattan
3 Includes midtown-downtown Manhattan (neighborhoods from 59th Street and below)
4 Includes uptown Manhattan (neighborhoods above 59th Street)
5 This average is based on five of the IPs visited. One pharmacy did not sell condoms.
6 This average is associated with 67 of the IPs visited. Three outlets provided free condoms.
7 This average is associated with 26 of the IPs visited. At three pharmacies, all condoms were free.
8 This average is associated with 34 of the GSs visited. Fourteen outlets visited did not sell condoms.
9 This average is associated with 14 of the GSs visited. Six outlets visited did not sell condoms.
10 This average is associated with 20 of the GSs visited. Eight outlets visited did not sell condoms.
11 This average is associated with six of the GSs visited. Four outlets visited did not sell condoms.
12 This average is associated with 14 of the GSs visited. Four outlets visited did not sell condoms.
13 This average is associated with 105 of the CSs visited. Three outlets visited offered only single condoms.
14 This average is associated with 47 of the CSs visited. Three outlets visited offered only single condoms.

Table 2: Analysis of Variance.

Source DF Adj SS Adj MS F-value P-value
Geographical location  3 39.85 13.283 23.34  0
Outlet  3 946.83 315.611 554.61  0
Geographical location * Outlet  9 196.07 21.786 38.28  0
Error 1581 899.7 0.569    
Total 1596 5941.04      




In 2015, 13% of Albany County residents lived below the federal poverty line [9]. Approximately 31% of the Bronx residents and overall, 18% of Manhattan residents, lived similarly [10]. Within these primary jurisdictions, however, different regions experienced different degrees of poverty. While the East Harlem and Washington Heights neighborhoods of uptown Manhattan experienced poverty rates of 31% and 27%, respectively, the Greenwich Village and Soho neighborhoods of downtown Manhattan each had a poverty rate of approximately 8% [10-12]. Based on these recent statistics and the data collected, it is evident that an inversely proportionate relationship often exists between the average costs of MLCs and poverty rate of a jurisdiction. Outlets located in the least poverty- stricken jurisdictions, Albany County and midtown-downtown Manhattan, often market boxes of MLCs at the highest average cost. The average price of MLCs tends to be lowest in the outlets of uptown Manhattan and the Bronx, the poorest jurisdictions of this study (Table 1).

Despite being frequented by the least poverty-stricken, midtown-downtown Manhattan is heavily affected by HIV, chlamydia, and gonorrhea [13]. While uptown Manhattan and the Bronx contrast from midtown-downtown Manhattan with respect to poverty level, they are similar in regards to the infection rate of STIs [13]. The cost of MLCs may contribute.

As illustrated in Figure 3, midtown-downtown Manhattan marketed MLCs at the highest average cost. Because the poverty rates in uptown Manhattan and the Bronx are significantly higher, there is the possibility that some residents in these neighborhoods believe MLCs are unaffordable. Essential living products that fail to be governmentally subsidized may take precedence. Considering substance abuse is notoriously higher in jurisdictions of higher poverty [14], funding an addiction may be of higher priority to some, as admitted to Essien et al., [4]. Hence, it is undoubtful that residents in many jurisdictions hold the perspective that outlets are over-priced.

Price Dispersion

In some jurisdictions, as denoted by the standard deviations calculated and price ranges observed (Table 1), price variation existed among various OCs, or sellers. The variation was more extensive among some sellers and in some locations than in others. From the price variation that appeared, the basic economic principle of price dispersion was evident.

As a result of the price dispersion throughout the different outlets and jurisdictions, it is unlikely that customers are always aware of the locations that market MLCs at the most desirable prices. Frequently, customers are familiar with only one price for products [15]. Some persons may be restricted and have limited access to particular outlets. Others may prefer making purchases only at specific locations. Furthermore, as Burke et al, discovered, some customers prefer certain brands of condoms [16]. The selection of MLCs is broader in some locations than in others, however.

Because the NCPs are highly recognized for health and hygiene products, they may provide some persons with more security than CSs at the time of purchasing MLCs. While some persons may be willing to pay more, some may refuse and place themselves at risk, even when there is shortage of a preferred brand. In consequence to the price dispersion, the social issues remain.

Condom Commercial Accessibility

MLCs are available at the majority of commercial locations. As current data are compared to the observations of Rizkalla et al [7], it is evident that condom availability has improved. Over twice the number GSs within the Bronx currently market MLCs. The fraction of CSs selling MLCs increased as well. The current placement of condoms in the pharmacies and stores is not always ideal and does not always grant customers easy access. The preferred open settings and specific shelving methods which ease condom purchasing, according to Sheldon-Scott et al. [17], are not particularly common. Instead, the highly secure placement observed by Rizkalla et al., in the Bronx remains a common practice. It is also common in multiple Albany County and Manhattan outlets.

Embarrassment likely results and is a purchase barrier [18- 20]. Self image and self presentation are common concerns. Individuals have previously expressed discomfort purchasing condoms as their anonymity decreased and visibility increased [19]. Because many, especially the youth, believe condom use and purchase may be misperceived for casual sex, STIs, and promiscuity [19], they often are deterred from purchasing the products. Having the opportunity to purchase condoms privately and independently is appreciated more than having to rely on the assistance of another party. Also, the restricted setting has led to the belief that condoms are forbidden [17].

Because the prevalence of STIs is higher in regions where these undesirable and restricted retail conditions are more common, it can be argued that the observed conditions are impacting condom purchase, condom use, and therefore the STIs. Until the selling approaches are modified, or cost-free MLCs become available at more locations, the retail conditions will continue to act as a culprit for the public health issues.

Finally, as respondents revealed, condoms are not always available for purchase. Frequently, they are placed out-of-reach, because they are high theft products. Inasmuch as the public is notorious for shoplifting MLCs at a high frequency, it is evident that individuals have a strong desire to use them and engage in risk-free sexual practices. For the benefit of society, selling methods and accessibility should improve.

Insurance Coverage

Condoms are similar to vaccines, for their dual role as STI barriers and a contraceptive classifies them as primary prevention. However, because the non-governmental HICs deny their coverage, it can be questioned if the complete purpose and valor of MLCs are fully understood by the non-governmental HICs.

As MLCs are excluded from plans of coverage, their efficacy and cost-effectiveness are overlooked. Aside from the costs related to unplanned pregnancy, the treatments of STIs are notoriously exorbitant. In 2010, the estimated lifetime cost of HIV treatment was approximately $379,668 per patient [20].

Furthermore, it is common for society to experience an occasional epidemiologic crisis. The international zika virus, for example, recently infected many in the United States. While the mosquito is the primary source of infection, the virus can be sexually-transmitted [21]. Undoubtedly, initial condom coverage has the potential to circumvent infection and costly healthcare services, including those associated with congenital defects. In many ways, despite what some HICs believe, it can be argued that MLCs are vital and do qualify as a medical necessity.

As non-governmental HICs fail to offer condom coverage and individuals engage in unsafe practices, the bioethical principles of beneficence and nonmaleficence are violated [22].

Moreover, a violation of social justice is apparent as Medicaid recipients have access to condom coverage and persons of a higher socioeconomic status receiving non-governmental health insurance do not. Social justice is further violated as females participating in private health plans receive contraceptive coverage, including condoms, and males do not. A simple resolution to these violations would be for all HICs to include condoms in the prescription formularies in the health plans of all patients.


From the data collected, it appears that it would be useful for more outlets and public locations to participate in programs that supply and distribute cost-free MLCs to society. While commercial sellers may consider modifying their selling practices, private HICs may consider revising their prescription formularies. Additionally, healthcare providers may contemplate providing routine counseling to all clients. To overcome the challenge of asking, the routine provision of condom prescriptions to the appropriate Medicaid recipients may be effective. The fraction of Medicaid recipients and clinicians aware of the condom coverage by many Medicaid plans, however, warrants questioning. Thus, educating healthcare providers may be essential.

Overall, as access to MLCs improves, the chances that STIs will be experienced less will increase.


I would like to thank Dr. Paul Feustal, Director of Research at Albany Medical College, for editing the manuscript and assisting with the statistical analysis. I would also like to thank Dr. Michael Gruenthal, Chair of Neurology, for editing the manuscript and reviewing the manuscript prior to submission. Furthermore, I appreciate Dr. Martha Lepow, Professor of Pediatric Infectious Disease; and Dr. Robin Tessinari, Professor of Psychiatry and Internal Medicine, for reviewing the manuscript prior to submission.


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8. Center for Disease Control (2015) HIV surveillance report.

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12. New York City Department of Health. (2015) Community Health Profiles Manhattan Community District 12.

13. New York City Department of Health. Sexually Transmitted diseases surveillance data.

14. Windsor LC, Dunlap E, Armour M. Surviving oppression under the rock: The intersection of New York’s drug, welfare, and educational polices in the lived experiences of low-income African Americans. J Ethn Subst Abuse. 2012; 11: 339-361.

15. Sorensen AT. Equilibrium price dispersion in retail markets for prescription drugs. Journal of Political Economy. 2000; 108: 833-850.

16. Burke RC, Wilson J, Bernstein KT, Grosskopf N, Murrill C, Cutler B, et al. The NYC condom: Use and acceptability of New York City’s branded condom. American Journal of Public Health. 2009; 99: 2178-2180.

17. Scott-Sheldon LA, Glasford DE, Marsh KL, and Lust SA. Barriers to condoms purchasing: effects of product positioning on reactions to condoms. Soc Sci Med. 2006; 63: 2755-2769.

18. Moore SG, Dahl DW, Gorn GJ, Weinberg CB. Coping with condom embarrassment. Psychol Health Med 2006; 11: 70-79.

19. Bell J. Why embarrassment inhibits the acquisition and use of condoms: a qualitative approach to understanding risky sexual behavior. J Adolesc. 2009; 32: 379-391.

20. Center for Disease Control and Prevention (2015) HIV Cost Effectiveness.

21. Center for Disease Control (2017) Zika Virus. 22.Tom L. Beauchamp and James F. Childress. (2009) Principles of biomedical ethics. Oxford University Press.

DeMase DF (2017) Costly Condoms or Costly Risks. J Family Med Community Health 4(8): 1137.

Received : 06 Sep 2017
Accepted : 10 Nov 2017
Published : 13 Nov 2017
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ISSN : 2379-0490
Launched : 2013
JSM Spine
ISSN : 2578-3181
Launched : 2016
Archives of Palliative Care
ISSN : 2573-1165
Launched : 2016
JSM Nutritional Disorders
ISSN : 2578-3203
Launched : 2017
Annals of Neurodegenerative Disorders
ISSN : 2476-2032
Launched : 2016
Journal of Fever
ISSN : 2641-7782
Launched : 2017
JSM Bone Marrow Research
ISSN : 2578-3351
Launched : 2016
JSM Mathematics and Statistics
ISSN : 2578-3173
Launched : 2014
Journal of Autoimmunity and Research
ISSN : 2573-1173
Launched : 2014
JSM Arthritis
ISSN : 2475-9155
Launched : 2016
JSM Head and Neck Cancer-Cases and Reviews
ISSN : 2573-1610
Launched : 2016
JSM General Surgery Cases and Images
ISSN : 2573-1564
Launched : 2016
JSM Anatomy and Physiology
ISSN : 2573-1262
Launched : 2016
JSM Dental Surgery
ISSN : 2573-1548
Launched : 2016
Annals of Emergency Surgery
ISSN : 2573-1017
Launched : 2016
Annals of Mens Health and Wellness
ISSN : 2641-7707
Launched : 2017
Journal of Preventive Medicine and Health Care
ISSN : 2576-0084
Launched : 2018
Journal of Chronic Diseases and Management
ISSN : 2573-1300
Launched : 2016
Annals of Vaccines and Immunization
ISSN : 2378-9379
Launched : 2014
JSM Heart Surgery Cases and Images
ISSN : 2578-3157
Launched : 2016
Annals of Reproductive Medicine and Treatment
ISSN : 2573-1092
Launched : 2016
JSM Brain Science
ISSN : 2573-1289
Launched : 2016
JSM Biomarkers
ISSN : 2578-3815
Launched : 2014
JSM Biology
ISSN : 2475-9392
Launched : 2016
Archives of Stem Cell and Research
ISSN : 2578-3580
Launched : 2014
Annals of Clinical and Medical Microbiology
ISSN : 2578-3629
Launched : 2014
JSM Pediatric Surgery
ISSN : 2578-3149
Launched : 2017
Journal of Memory Disorder and Rehabilitation
ISSN : 2578-319X
Launched : 2016
JSM Tropical Medicine and Research
ISSN : 2578-3165
Launched : 2016
JSM Head and Face Medicine
ISSN : 2578-3793
Launched : 2016
JSM Cardiothoracic Surgery
ISSN : 2573-1297
Launched : 2016
JSM Bone and Joint Diseases
ISSN : 2578-3351
Launched : 2017
JSM Bioavailability and Bioequivalence
ISSN : 2641-7812
Launched : 2017
JSM Atherosclerosis
ISSN : 2573-1270
Launched : 2016
Journal of Genitourinary Disorders
ISSN : 2641-7790
Launched : 2017
Journal of Fractures and Sprains
ISSN : 2578-3831
Launched : 2016
Journal of Autism and Epilepsy
ISSN : 2641-7774
Launched : 2016
Annals of Marine Biology and Research
ISSN : 2573-105X
Launched : 2014
JSM Health Education & Primary Health Care
ISSN : 2578-3777
Launched : 2016
JSM Communication Disorders
ISSN : 2578-3807
Launched : 2016
Annals of Musculoskeletal Disorders
ISSN : 2578-3599
Launched : 2016
Annals of Virology and Research
ISSN : 2573-1122
Launched : 2014
JSM Renal Medicine
ISSN : 2573-1637
Launched : 2016
Journal of Muscle Health
ISSN : 2578-3823
Launched : 2016
JSM Genetics and Genomics
ISSN : 2334-1823
Launched : 2013
JSM Anxiety and Depression
ISSN : 2475-9139
Launched : 2016
Clinical Journal of Heart Diseases
ISSN : 2641-7766
Launched : 2016
Annals of Medicinal Chemistry and Research
ISSN : 2378-9336
Launched : 2014
JSM Pain and Management
ISSN : 2578-3378
Launched : 2016
JSM Women's Health
ISSN : 2578-3696
Launched : 2016
Clinical Research in HIV or AIDS
ISSN : 2374-0094
Launched : 2013
Journal of Endocrinology, Diabetes and Obesity
ISSN : 2333-6692
Launched : 2013
Journal of Substance Abuse and Alcoholism
ISSN : 2373-9363
Launched : 2013
JSM Neurosurgery and Spine
ISSN : 2373-9479
Launched : 2013
Journal of Liver and Clinical Research
ISSN : 2379-0830
Launched : 2014
Journal of Drug Design and Research
ISSN : 2379-089X
Launched : 2014
JSM Clinical Oncology and Research
ISSN : 2373-938X
Launched : 2013
JSM Bioinformatics, Genomics and Proteomics
ISSN : 2576-1102
Launched : 2014
JSM Chemistry
ISSN : 2334-1831
Launched : 2013
Journal of Trauma and Care
ISSN : 2573-1246
Launched : 2014
JSM Surgical Oncology and Research
ISSN : 2578-3688
Launched : 2016
Annals of Food Processing and Preservation
ISSN : 2573-1033
Launched : 2016
Journal of Radiology and Radiation Therapy
ISSN : 2333-7095
Launched : 2013
JSM Physical Medicine and Rehabilitation
ISSN : 2578-3572
Launched : 2016
Annals of Clinical Pathology
ISSN : 2373-9282
Launched : 2013
Annals of Cardiovascular Diseases
ISSN : 2641-7731
Launched : 2016
Journal of Behavior
ISSN : 2576-0076
Launched : 2016
Annals of Clinical and Experimental Metabolism
ISSN : 2572-2492
Launched : 2016
Clinical Research in Infectious Diseases
ISSN : 2379-0636
Launched : 2013
JSM Microbiology
ISSN : 2333-6455
Launched : 2013
Journal of Urology and Research
ISSN : 2379-951X
Launched : 2014
Annals of Pregnancy and Care
ISSN : 2578-336X
Launched : 2017
JSM Cell and Developmental Biology
ISSN : 2379-061X
Launched : 2013
Annals of Aquaculture and Research
ISSN : 2379-0881
Launched : 2014
Clinical Research in Pulmonology
ISSN : 2333-6625
Launched : 2013
Journal of Immunology and Clinical Research
ISSN : 2333-6714
Launched : 2013
Annals of Forensic Research and Analysis
ISSN : 2378-9476
Launched : 2014
JSM Biochemistry and Molecular Biology
ISSN : 2333-7109
Launched : 2013
Annals of Breast Cancer Research
ISSN : 2641-7685
Launched : 2016
Annals of Gerontology and Geriatric Research
ISSN : 2378-9409
Launched : 2014
Journal of Sleep Medicine and Disorders
ISSN : 2379-0822
Launched : 2014
JSM Burns and Trauma
ISSN : 2475-9406
Launched : 2016
Chemical Engineering and Process Techniques
ISSN : 2333-6633
Launched : 2013
Annals of Clinical Cytology and Pathology
ISSN : 2475-9430
Launched : 2014
JSM Allergy and Asthma
ISSN : 2573-1254
Launched : 2016
Journal of Neurological Disorders and Stroke
ISSN : 2334-2307
Launched : 2013
Annals of Sports Medicine and Research
ISSN : 2379-0571
Launched : 2014
JSM Sexual Medicine
ISSN : 2578-3718
Launched : 2016
Annals of Vascular Medicine and Research
ISSN : 2378-9344
Launched : 2014
JSM Biotechnology and Biomedical Engineering
ISSN : 2333-7117
Launched : 2013
Journal of Hematology and Transfusion
ISSN : 2333-6684
Launched : 2013
JSM Environmental Science and Ecology
ISSN : 2333-7141
Launched : 2013
Journal of Cardiology and Clinical Research
ISSN : 2333-6676
Launched : 2013
JSM Nanotechnology and Nanomedicine
ISSN : 2334-1815
Launched : 2013
Journal of Ear, Nose and Throat Disorders
ISSN : 2475-9473
Launched : 2016
JSM Ophthalmology
ISSN : 2333-6447
Launched : 2013
Journal of Pharmacology and Clinical Toxicology
ISSN : 2333-7079
Launched : 2013
Annals of Psychiatry and Mental Health
ISSN : 2374-0124
Launched : 2013
Medical Journal of Obstetrics and Gynecology
ISSN : 2333-6439
Launched : 2013
Annals of Pediatrics and Child Health
ISSN : 2373-9312
Launched : 2013
JSM Clinical Pharmaceutics
ISSN : 2379-9498
Launched : 2014
JSM Foot and Ankle
ISSN : 2475-9112
Launched : 2016
JSM Alzheimer's Disease and Related Dementia
ISSN : 2378-9565
Launched : 2014
Journal of Addiction Medicine and Therapy
ISSN : 2333-665X
Launched : 2013
Journal of Veterinary Medicine and Research
ISSN : 2378-931X
Launched : 2013
Annals of Public Health and Research
ISSN : 2378-9328
Launched : 2014
Annals of Orthopedics and Rheumatology
ISSN : 2373-9290
Launched : 2013
Journal of Clinical Nephrology and Research
ISSN : 2379-0652
Launched : 2014
Annals of Community Medicine and Practice
ISSN : 2475-9465
Launched : 2014
Annals of Biometrics and Biostatistics
ISSN : 2374-0116
Launched : 2013
JSM Clinical Case Reports
ISSN : 2373-9819
Launched : 2013
Journal of Cancer Biology and Research
ISSN : 2373-9436
Launched : 2013
Journal of Surgery and Transplantation Science
ISSN : 2379-0911
Launched : 2013
Journal of Dermatology and Clinical Research
ISSN : 2373-9371
Launched : 2013
JSM Gastroenterology and Hepatology
ISSN : 2373-9487
Launched : 2013
TEST Journal of Dentistry
ISSN : 1234-5678
Launched : 2014
Annals of Nursing and Practice
ISSN : 2379-9501
Launched : 2014
JSM Dentistry
ISSN : 2333-7133
Launched : 2013
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