Recommendations

Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.

This guideline was developed as a result of a review of NICE guideline PH3 (published February 2007). See the original NICE guideline and supporting documents.

1.1 Targeting services

1.1.1 Provide a range of condom distribution schemes (also known as condom schemes) to meet the needs of different local populations, based on needs assessment, consultation and sexually transmitted infection (STI) rates. Target those most at risk. Include multicomponent schemes, single component schemes (free condoms) and cost-price sales schemes.

1.1.2 Provide condom schemes as part of existing services that are likely to be used by those most at risk. This could include services provided by the voluntary sector (such as advice projects and youth projects), school health services and primary healthcare (including GP surgeries and community pharmacies).

1.1.3 Ensure links exist between condom schemes and local sexual and reproductive health services. For example, consider:

  • Providing condoms with information about local sexual health services.

  • Displaying posters and providing leaflets advertising local sexual health services where condoms are available.

1.1.4 Publicise condom schemes to people most at risk of getting an STI. For example:

  • Put posters and leaflets in places used by those most at risk.

  • Advertise on geospatial social networking apps (used to find local sexual partners) or websites (such as the NHS condom locator) and social media.

1.2 Multicomponent schemes for young people in health, education, youth and outreach settings

Service organisation

1.2.1 Provide tailored multicomponent condom schemes in preference to other types of condom scheme for young people aged up to 16 and others for whom there is a duty of care.

1.2.2 Consider extending tailored multicomponent condom schemes to include all young people up to the age of 25.

1.2.3 Integrate these schemes into broader services for young people, for example, as part of young people's sexual and reproductive health services (see NICE's guideline on contraceptive services for under 25s).

1.2.4 Offer pathways into other services including: sexual and reproductive health, alcohol and drug, mental health and partner violence services, as needed.

1.2.5 Ensure services:

  • meet the Department of Health's You're Welcome criteria for young-person-friendly services

  • are confidential

  • are sited in settings accessible to young people for example, in health, education, youth and outreach settings and in a range of geographical areas

  • are accessible by public transport

  • are available at convenient times for young people (for example, after school, college or university and at weekends).

1.2.6 Ensure the safety of young people by:

  • Assessing the competence of those under 16, and others for whom there is a duty of care, before providing them with condoms.

  • Being alert to signs of child sexual exploitation or abuse, including intimate partner violence. See Spotting the signs of CSE proforma (British Association for Sexual Health and HIV and Brook) and NICE's guideline on child maltreatment.

  • Agreeing with the young person how they will use the scheme. This should take into account their age and circumstances and include an agreement that after a specified number of visits they will discuss their relationships and condom use again.

1.2.7 Consider providing a range of condom types (for example, latex-free) and sizes, female condoms and dental dams. Include lubricant as well as condoms if they need or want it.

Information and advice

1.2.8 Tailor information and advice according to the young person's needs and circumstances, including their sexual identity and whether or not they are having sex or are in a relationship.

1.2.9 Discuss the effect that alcohol and drugs can have on decision-making and their ability to consent.

1.2.10 Teach young people to use condoms effectively and safely (using education, information and demonstrations) before providing them.

1.2.11 Provide information about emergency contraception and post-exposure prophylaxis so that young people know what to do and where to go in the event of a condom failure.

1.3 Single component schemes

Free condoms

1.3.1 Consider distributing free condoms (with lubricant) to people at most risk of STIs through:

  • Commercial venues (including sex-on-premises venues), public sex environments and other places where people are at more risk of getting an STI.

  • Local businesses that people most at risk of STIs may use, for example, some community pharmacies.

  • Voluntary and community organisations that work with those at most risk, for example, sexual health charities.

  • Other settings, such as universities and further education settings.

1.3.2 Provide information next to supplies of condoms (the information should be in line with NICE's guidelines on behaviour change: general approaches and behaviour change: individual approaches). This could include information about:

  • sexual and reproductive health

  • reliable sources of further information (for example, NHS Choices)

  • other condom schemes (including multicomponent schemes)

  • local sexual health services, including HIV testing services

  • what to do in the event of a condom failure.

1.3.3 Ensure supporting information is sensitive to the environment where it is displayed, for example in terms of language and the images used.

Cost-price sales schemes

1.3.4 Sell cost-price condoms to the wider population using websites run by existing health and wellbeing services, or larger-scale online condom sales schemes.

1.3.5 Provide information about using condoms and about sexual and reproductive health at the point of sale (see recommendation 1.3.2).

Terms used in this guideline

This section defines terms that have been used in a specific way for this guideline. For general definitions, please see the glossary.

Condom distribution schemes

Mainly referred to as 'condom schemes' in this guideline. The term refers to all schemes that provide free or cost-price condoms, female condoms and dental dams, with or without lubricant. This includes schemes that also offer advice, information or support.

Cost-price sales schemes

These schemes provide cost-price condoms and, if appropriate, lubricant. They include community schemes that provide cost-price condoms to sex workers and online services.

Multicomponent schemes

These schemes distribute free condoms with or without lubricant, together with training, information or other support.

Single component schemes

These schemes provide or distribute free condoms and if appropriate, lubricant. This includes online services for specific groups or areas of the country, and distribution schemes in public places.

  • Public Health England – Alcohol and drug misuse prevention and treatment collection
  • National Institute for Health and Care Excellence (NICE)