Prophylactic Measures

When Keith Eby found condoms locked at his neighborhood CVS, he turned elsewhere. Giant, Safeway and Shoppers also lock condoms where theft is high.
When Keith Eby found condoms locked at his neighborhood CVS, he turned elsewhere. Giant, Safeway and Shoppers also lock condoms where theft is high. (By Mark Gail -- The Washington Post)
By Suz Redfearn
Special to The Washington Post
Tuesday, April 11, 2006

Sindy Dominguez, 17, of Hyattsville already had a baby, and didn't want another -- at least not until she'd established a home and a career. Three months after her daughter was born, she and her boyfriend went to the CVS pharmacy near their apartment to buy a large box of condoms. They found them locked in a case equipped with a button that read "push for assistance."

They pushed, and heard a call for help for a pharmacist, but no one came. They pushed again. And again.

"My boyfriend said, 'Do you want to just leave?' and I said, 'Yes, let's just go,' " said Dominguez. "We went to a nearby gas station and bought a few single condoms."

Keith Eby had a somewhat similar experience. A day after the 37-year-old health-care consultant found the condoms locked up at his neighborhood CVS at Logan Circle, he tried the CVS on M Street in Georgetown, near his office. Same problem.

"I don't get embarrassed easily, but even I couldn't imagine ringing a buzzer and having everyone in the store know I was purchasing condoms," said Eby. "I can't even imagine what that must be like for someone who does get embarrassed easily or is not comfortable with their sexuality."

Finally Eby remembered that a new CVS had opened across the street in the Ritz-Carlton. He went in and found the condoms unlocked and available on the shelf. He said he bought many so he wouldn't have to go through this again anytime soon.

But Eby remains upset about his experience.

"CVS is going to contribute to a huge increase in HIV infection rates by creating a barrier to getting condoms in their stores," he said.

When experts call condoms a barrier method of birth control, this isn't what they mean.

An informal survey found that almost half -- 22 of 50 -- of the District's CVS pharmacies lock up their condoms -- this in a city where one in 20 residents is HIV-positive. Most of those stores are in less affluent areas where the incidence of HIV/AIDS, other sexually transmitted diseases and unwanted pregnancy -- all preventable with condoms -- are highest. Many CVS stores in the close-in Prince George's County suburbs also lock up condoms.

CVS, the leading drugstore chain in the Washington area, is not alone. Some Safeway and Giant stores in the District also lock up condoms, as do most Shopper's Food & Pharmacy Warehouse stores in the nearby suburbs. (Two chains that don't lock them up, no matter where their stores are located, are Rite-Aid and Eckerd.)

Some who work in public health are alarmed.

"Numerous barriers [to contraception] already exist -- particularly for minority populations," said Nestor Rocha, director of the Disease Prevention and Health Promotion Division of the Whitman-Walker Clinic, which hands out condoms for free. "To add to that that someone has to ask for them out loud in front of other customers is simply making it so that people who could benefit from the use of condoms will not."

Sex and Thievery

Mike DeAngelis, a CVS spokesman, says the practice of locking up condoms is simply a response to theft.

"We're not trying to restrict access -- we're trying to prevent people from stealing," he said.

Lockups are decided on a case-by-case basis, he said. In stores reporting high theft, the company permits managers to lock up not just condoms but other high-theft items like hair-care products, baby formula and pregnancy tests, he said. DeAngelis declined to disclose theft statistics for any CVS pharmacies, or to say when any individual stores began locking up their condoms.

Heather Boonstra, policy analyst for the Alan Guttmacher Institute, a think tank that focuses on sexual health, doesn't buy the theft rationale.

"It's an economic thing," she says. "It goes back to prejudice and fear. In those areas of the city that are poor, stores fear that people are going to steal the product -- whether they actually do or not."

DeAngelis takes issue with that, citing shoplifting rings that resell condoms on the street. He declined to identify which stores were affected and how costly these thefts have become.

Donna Evans, director of Shoppers Food & Pharmacy Warehouse's health and beauty category, under which condoms fall, said the Shoppers chain permits locking up condoms when loss from suspected theft is shown to be in the 20 percent range.

Safeway and Giant say that while their corporate policy is not to lock up condoms, they let individual stores decide, based on theft numbers.

Lessons Learned

Whatever the rationale, locking up condoms discourages their use.

Christine Spencer-Grier, director of community education at Planned Parenthood of Metropolitan Washington, has seen that firsthand. She helps run a program that assists teen mothers in avoiding another pregnancy. One of the program's projects has the young moms venture out to buy condoms and report back on their experiences.

Spencer-Grier said many come back talking of being too embarrassed to buy once they saw they would have to ask for help. Others reported that, when they asked a salesperson for assistance, they got dirty looks or a lecture about being too young for sex.

"Teens are very sensitive to a disparaging look, a lecture -- all of those things are very intimidating," said Spencer-Grier. Many girls, she said, left the stores ashamed and empty-handed -- but still likely to have sex.

Not all groups with a stake in sexual health oppose the lockup policy.

Citizens for Community Values -- which promotes abstinence as the answer to sexually transmitted diseases and unwanted pregnancies -- applauds adding steps to buying condoms.

"I'd rather see them locked up," said Phil Burress, president of the organization. "It's a lie that condoms prevent all sexually transmitted diseases anyway. People should be educated about that and practice abstinence." But there is little impartial evidence of measurable benefits from abstinence-only policies, say scientists.

Burress pointed to a 2001 National Institute of Allergy and Infectious Diseases report showing that condoms aren't effective in preventing the spread of the human papillomavirus (HPV). But, according to the NIAID report, condoms are considered effective against unwanted pregnancy (86 to 97 percent), HIV/AIDS (85 percent) and gonorrhea in men (49 to 74 percent).

But an argument that all stores take their condoms out from behind lock and key prompts resistance. If stores did that, says DeAngelis, theft would be so high, they'd have to discontinue the product altogether.

"We're trying to keep our products available for our customers who are purchasing these products legitimately," he said. "Locking them is the only way."

At this point, Dominguez, the Hyattsville teen mom who was frustrated in her efforts to buy condoms at her local CVS, doesn't much care whether her local pharmacy locks up its condoms.

"I don't think I'll ever buy them for myself," she said. "That experience turned me off." ยท

Suz Redfearn last wrote for Health about a National Library of Medicine exhibit on forensic medicine. Comments:

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