Don’t let your community get bitten. Ask for a snake

Rachel Molloy, MSIA; Bev Greet, VACCHO; Ken Knight, MAHS

Suggested citation: Molloy R, Greet B, Knight K (2005) Don’t let your community get bitten. Ask for a snake. Australian Indigenous HealthBulletin;5(1): Brief report 1. Retrieved [access date] from
http://www.healthinfonet.ecu.edu.au/html/html_bulletin/bull_51/brief_reports/bulletin_brief_reports_snake.htm

On 28 March 2004 Mildura celebrated the launch of Australia’s first ever Indigenous friendly socially marketed condom brand, snake condoms. Approximately 2,000 people attended Snakefest, the free concert, which featured performances by prominent Australian chart toppers including Shakaya and Mercury 4, as well as hip hop artists Brothablack, Little G and R&B singer Dalys. The event was jointly hosted by Aaron Pedersen, Channel 9’s ‘Water Rats’ Indigenous star, and Rachel Molloy, Marie Stopes International Australia’s (MSIA) National Marketing and Program Manager.

Snake condoms are part of a new condom social marketing campaign that promotes subsidised condoms. By using marketing approaches that educate, change attitudes and positively affect social behaviour in terms of safer sex practices, the initiative aims to help reduce unplanned teenage pregnancies and the spread and incidence of sexually transmitted infections (STIs) including HIV/AIDS among Indigenous communities.

The initiative was prompted by the worrying sexual and reproductive health trends impacting Indigenous people. Rates for teenage pregnancy and STIs are remarkably high among the Aboriginal population, and the rate of HIV/AIDS notification is increasing.

The new snake condoms brand is the culmination of 18 months of close collaboration between MSIA, the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) and the Mildura Aboriginal Health Service. The project was piloted in Mildura and surrounding towns.

As a result of the campaign:

  • Indigenous people aged 16-30 are now more likely to use condoms
  • Indigenous people aged 16-30 are now more worried about having unsafe/unprotected sex
  • Indigenous people aged 16-30 have a high recall and purchase of snake condoms – with a greater proportion of respondents recalling and purchasing snake condoms compared with any other brand in the piloted area.

Based on the successes of the pilot, a nation-wide expansion strategy is being formulated, to allow Indigenous people from all over Australia to benefit from this innovative campaign.

Why condom social marketing?

Condom social marketing has also been used to great effect in many Marie Stopes’ programs internationally. Social marketing aims to ensure that condoms reach the groups who most need them, in an affordable and accessible way, so the product is typically subsidised and made available through both traditional and non-traditional outlets. As pointed out by the U.S. Agency for International Development, ‘Social marketing has been the single most important contribution that the family planning field have made to the prevention of HIV/AIDS and other STIsi.’ The World Health Organisation confirms this approach and acknowledges that ‘condom social marketing programs have succeeded in increasing the use of condoms in many countriesii.’

The idea for the snake condoms social marketing initiative arose from an earlier VACCHO-MSIA initiative, PhotoVoice, during which young Indigenous people in three communities (including Mildura) used photography as a means to identify their important sexual and reproductive health issues. One of the very strong messages to come from this initiative was the need for better access to condoms to help young people practise safe sex and reduce unwanted pregnancies and STIs.

Further research also identified a range of social and cultural barriers to condom use in Indigenous communities, particularly, that the distribution of free condoms has had little or no impact. It was also generally felt that condom brands in the marketplace targeted white Australians and were not in any way culturally relevant to Indigenous Australians.

Therefore, to overcome these barriers, a new condom brand needed to be developed which was highly appealing to Indigenous people.

The brand

Local youth worked closely with the MSIA, VACCHO, MAHS and cummins&partners advertising agency throughout the product development phase.

As suggested by a number of young Indigenous people, the new condom was named snake, which is symbolic of Indigenous culture. Most importantly, snake lends itself to some fun and cheeky innuendo to which teenagers can relate.

 

The snake condoms logo also integrated preferences cited by the Mildura community, including strong use of the colours of the Aboriginal flag, as well as a blend of traditional and modern Indigenous art.

The product

Snake condoms are flavoured and come in the colours of the Aboriginal flag – red for strawberry, yellow for vanilla and black for chocolate. They are ultra thin to feel more natural and are sold in discreet sized packs of three, so they can easily fit in a pocket or purse.

The price

Most young people that took part in the research viewed condoms as being too expensive, so MSIA and VACCHO needed to ensure that the new brand was affordable and didn’t compete with other products such as alcohol or cigarettes. The condoms also needed to be available at a subsidised price, but without being ‘too cheap’ which would create the perception that they are poor quality. Taking these factors into account, it was decided that the recommended retail price for snake condoms be $2.00, which is affordable to even the most vulnerable groups. All proceeds from the condom sales contribute to project sustainability, thus reducing reliance on donor funding.

The distribution

In addition to traditional retail outlets such as supermarkets, chemists, local convenience stores, service stations and the MAHS, snake condoms are also available at late night eateries, burger vans and pubs and cafes.

Most importantly, they are being distributed via a peer seller network. For the first time in Australia, young Indigenous people have been trained as peer sellers and are distributing the new condom brand at parties and other places where young people gather – as this is where many key decisions regarding sexual behaviour are being made. They buy the condoms at a subsidised price and retain any profits that they make from sales to the community.

The advertising

Snake condoms (and the safe sex message) are being promoted through a print, poster, transit and radio advertising campaign.

In addition, branded merchandise was developed to reinforce brand awareness. This includes men’s and women’s T-shirts, caps, visors and key-ring condom holders.

 

An educational flyer was developed to increase knowledge and awareness about the importance of using a condom, as well as the importance of correct and consistent use. These are being widely distributed by retail outlets stocking the brand, as well as through the peer seller network.

Evaluation

Cultural Perspectives conducted the benchmark and evaluation studies in collaboration with the MAHS. These studies served as pre-project and post-project indicators, evaluating the effectiveness of the manner in which the project was conducted and the impact of the Condom Social Marketing for Indigenous Australia Mildura area pilot initiative. The respondents were Indigenous people between 13 and 30 years.

The findings

Condom use

Since the launch of the snake condoms brand in Mildura, there has been a significant improvement in the rates of condom use among sexually active respondents of the targeted community. Survey respondents were asked how often they used condoms when having sex. As can be noted in the following table, the results indicate that the evaluation respondents are more likely to ‘always use a condom’ (58%) than among the benchmark respondents (40%). The research also showed an increase from 15% to 19% in the number of respondents who ‘usually use a condom’.

Benchmark

(n=98)

Evaluation

(n=52)

Always use a condom

40%

58%

Usually use a condom

15%

19%

Sometimes use a condom

17%

4%

Very rarely use a condom

26%

19%

Never use a condom

2%

0%

Similarly the respondents in the evaluation were much more likely to have used a condom during the last act of sexual intercourse (62%) than the benchmark survey respondents (42%).

Attitudes toward unsafe/unprotected sex

Since the launch of a socially marketed condom brand in the Mildura community, there have been significant shifts in attitudes of members of the targeted groups. The results indicate that the evaluation survey respondents, were considerably more likely than the benchmark survey respondents to be worried when they have unsafe/unprotected sex. As can be noted in the following table, there was a significant increase from 21% to 46% in the number of respondents who were ‘really worried’ about unsafe/unprotected sex. Similarly, there was a significant decrease from 34% to 11% in the number of respondents who ‘do not worry’ about unsafe/unprotected sex at all.

Benchmark

(n=99)

Evaluation

(n=57)

I do not worry about it at all

34%

11%

I worry about it a bit, but forget about it quickly

16%

11%

I worry about it quite a bit

28%

33%

I am really worried about this

21%

46%

As can be noted in the following graphs, Indigenous people aged 16-30 have a high recall and purchase of snake condoms – with a greater proportion of evaluation respondents recalling and purchasing snake condoms compared with any other brand in the piloted area.

Sales achieved

Since snake condoms were launched in Mildura on 28th March, 2004, over 15,000 condoms have been sold. This outcome is extremely positive considering the relatively small Indigenous population of Mildura (3,000-5,000 people) and once again indicates the popularity of the brand among members of the targeted community.

The conclusion

In conclusion, the response to the Condom Social Marketing Initiative for Indigenous Australia has been extremely positive, especially given the relatively short time frame since its inception. The initiative has been a remarkable opportunity to promote sexual and reproductive health and the prevention of STIs, including HIV/AIDS, as well as providing contraceptive protection for young Indigenous people.

As a result of the campaign, the availability and accessibility of condoms has significantly improved. By making condoms more accessible to Indigenous people at places where they regularly gather and at times when they are making decisions about their sexual behaviour, this initiative has helped reach new groups of potential users. Also, making condoms more available has raised their visibility and made them more familiar to Indigenous people, helping to overcome taboos. Furthermore, by creating a product that is culturally relevant and highly appealing to the Indigenous community, this initiative has encouraged them to actually buy the product and use it.

The recommendations

The project partners strongly endorse the introduction of a nationwide campaign so that the same sexual and reproductive health benefits can be offered to other Indigenous communities across the country. It will only be when the elements of a nationwide strategy are implemented, that there will be possibility of lasting change.

Partnerships with key Indigenous organisations, local community input for guiding programming decisions, as well as working within the principles of Aboriginal self-determination and community control were key to the success of the initiative. A big thank you to the local Indigenous community in Mildura for making the initiative possible.

Further information

MSIA and VACCHO are currently gathering expressions of interest from communities around Australia. If you think your community would benefit from this campaign, please contact Rachel Molloy on (03) 9593 9651 or email rachel.molloy@mariestopes.org.au

The snake condoms initiative has been made possible by the Commonwealth Government Office for Aboriginal and Torres Strait Islander Health, cummins&partners, Cultural Perspectives, Virgin Blue and 99.5 Star FM.

Endnotes

i U.S. Agency for International Development, Social Marketing for STI Prevention, 1999
ii World Health Organization, STI/HIV Promoting Condoms in Clinics for Sexually Transmitted Infections, 2001.

The HealthInfoNet visits Darwin to conduct workshops and participate at the Chronic Diseases Network Conference

Glenda Trevaskis and Sam Burrow from the HealthInfoNet recently visited Darwin to conduct HealthInternet workshops and participate at the 8th annual Chronic Diseases Network Conference. Negotiations with the NT Department of Health and Community Services (NTDHCS) and local key Indigenous health worker training providers lead to arrangements to conduct two separate ½ day workshops to provide Internet training to Indigenous health workers, prior to the commencement of the conference.

The workshops were conducted at the Danila Dilba Education and Training Centre on 22 September, 2004. They aimed to provide a hands-on opportunity for Indigenous health workers to:

  • improve their Internet skills and knowledge;
  • enhance their utilisation of the HealthInfoNet website; and
  • provide feedback on how the website could be developed to better meet their information needs.

A total of twenty-one Indigenous health workers from NTDHCS, the Katherine West Health Board and Danila Dilba Medical Services attended. Participants were shown how to access the website, were provided with information about different aspects of the site, and were taken through a number of exercises which allowed them to explore the site at their own pace.

Given the diverse background of workshop participants and differences in their access to and use of computer technology, the workshops were well received and provided constructive feedback for developing the site further. Health workers in other areas have expressed interest in workshops of this type and with adequate funding opportunities may exist to develop and conduct similar workshops in other States and Territories in the future.

In the two days following the workshops HealthInfoNet staff attended the Chronic Diseases Network Conference – The Turning Tide: Action and Improvements in Chronic Disease. The conference was hosted by the Chronic Diseases Network and the Good Health Alliance NT and held from 23-24 September, 2004. The conference aimed to bring together local, national and international speakers to talk about the results of working in innovative and creative ways and improving the ways we work together to support and build healthier communities.

Conference presentations included:
• Dr. Dianne Howard, Endocrinologist, RDH, Darwin, NT. Historical perspectives of chronic disease in the NT
• Prof. David Simmons, University of Auckland, NZ. The Pacific Perspective – Chronic Disease
• Des Rogers, Director, Red Centre Produce, NT. Risky Business – a personal perspective
• Prof. Kerin O’Dea, Director, Menzies School of Health Research, Darwin, NT. Tackling chronic disease: how research can inform future strategies
• Dr. Christine Connors, Program Director, Preventable Chronic Diseases, Darwin, NT. Thinking Differently
• Malcolm Battersby, Director of the Human Behaviour and Health Research Unit and Senor Lecturer in Psychiatry, Flinders University, SA. Lessons from America
• Dr. Paul Ireland, National Institute of Clinical Studies. Filling the Gaps – The Gaps Report
• Peter Holt, Indigenous Program Coordinator, Fred Hollows Foundation. Developing new partnerships – philanthropic organisations and business
• Anne Kemp, CEO, Diabetes Australia NT and Health Living, NT. Good health for a good country – impact of non government organisations on chronic disease
• Inez Carter, Apunipima Cape York Health Council, Qld. Giving kids a good start – Foetal Alcohol Syndrome Project

Sam and Glenda conducted a HealthInternet café at the conference to give delegates an informal opportunity to learn about web-based health information and other HealthInfoNet services such as training and website development. They also participated in a concurrent session which explored the use of communication technologies to support Indigenous yarning and the sharing of health information.

Whilst visiting Darwin a number of meetings were arranged with other organisations and individuals involved in Indigenous health to promote and discuss the benefits of utilising HealthInfoNet services. The organisations included the Aboriginal Medical Services Alliance NT (AMSANT), Office for Aboriginal and Torres Strait Islander Health (OATSIH), NT Menzies School of Health Research, Cooperative Research Centre for Aboriginal Health (CRC) and Batchelor Institute of Indigenous Tertiary Education. The visit to Batchelor Institute provided another opportunity to spend time with Indigenous health worker students to demonstrate the use of the website, and to discuss how the information available might be used in their day-to-day practice.

For further details about the 8th annual Chronic Diseases Network Conference view the Northern Territory Department of Health and Community Services website.

We would like to thank the workshop and conference participants who provided written permission for us to display their photos here