Does condom availability make a difference? An evaluation of Philadelphia’s health resource centers. Family Planning Perspectives

vary somewhat in their specific goals, most share the same premise: Expanded condom availability will increase the pro-portion of protected sexual encounters, particularly when it is accompanied by ed-ucation and information about safer sex. Opponents have responded that distrib-uting condoms in a school will legitimate and thus increase the prevalence of sexu-al intercourse among students there.5 To date, only two studies have directly evaluated the impact of condom distri-bution on rates of protected and unpro-tected intercourse among teenagers in schools with such services.6 Our study is one of the first to examine whether con-dom access programs increase the inci-dence of protected sex, as proponents claim, and whether providing condoms in schools promotes sexual activity among students, as critics argue. Answering these questions poses a se-ries of methodological challenges. Ideal-ly, a program evaluation should employ an experimental design that randomly as-signs programs to schools or individuals to programs. These approaches are diffi-cult to implement for both ethical and or-ganizational reasons. A more practical, if not wholly desirable, alternative involves comparing changes in behavior over time in schools where programs have been ini-tiated and in similar schools without pro-grams. This approach requires time-series or, better, longitudinal data on youths in both types of schools. To our knowledge