of lower socioeconomic status. Most schools with condom availability programs are located in Los Angeles and New York City because of these cities' mandates on condom availability. Condom availability programs have used a variety of mechanisms for distributing condoms in schools (Stryker et al., 1994; Advocates for Youth, 1995; Kirby and Brown, 1996). Many schools provide condoms through school health professionals, teachers, principals, or counselors. In only a small percentage of cases are condoms provided in bowls and baskets (5 percent) or through vending machines (3 percent) (Kirby and Brown, 1996). In 81 percent of schools with programs, some type of parental consent (active or passive) is required for student participation. Approximately half of schools that make condoms available require education and counseling before condoms are provided; students are commonly informed regarding use of condoms and that not having sex is the best protection against STDs. An analysis of utilization of condom availability programs showed that students in alternative schools, smaller schools, schools that made condoms available through bowls and baskets, and schools with health clinics obtained more condoms per person per year than did students in other schools (Kirby and Brown, 1996).
There are only limited data on the effectiveness of condom availability programs in schools to increase protective sexual behaviors and decrease STD rates, since these programs are relatively few and newly established (Kirby, 1993; Stryker et al., 1994). In addition, many condom availability programs were not designed to measure program effectiveness (Stryker et al., 1994). One study, however, estimated that an additional 6 to 13 percent of students would have had sexual intercourse without protection if their school had not provided contraceptives (Kirby et al., 1991). Preliminary data from the evaluation of the New York City program indicate that girls considered embarrassment and confidentiality concerns as main barriers to using the program (Guttmacher et al., 1995a). After implementation of condom availability programs in New York City high schools, 69 percent of parents surveyed supported condom availability for their children in school; 85 percent believed that providing condoms to students would either have no effect on, or would decrease the frequency of, sexual activity among the students; and 75 percent believed that providing condoms would result in students practicing safer sex (Guttmacher et al., 1995b).
There seems to be wide public support for school condom availability programs. A 1991 survey showed that 74 percent of adults surveyed favored condom availability in high school and 47 percent favored availability in junior high schools (The Roper Organization, 1991). Among Denver high school students, 85 percent believed that condoms should be provided in their school and 76 percent believed that having access to condoms would not affect the frequency of sexual activity among students (Fanburg et al., 1995). In New York City public high schools where passive parental permission is required for participation, fewer than 2 percent of parents have submitted written denials of participation for their children (Guttmacher et al., 1995b). Health care provider groups have