"After understanding the income and consumers' attitude to sex in lower-tier cities, delivering affordable products, seeking suitable retail partners and distributing the products have become three priorities to us," Arias says.

"New condoms made by synthetics and condoms with medical functions will be introduced to China soon."

A survey by China Sexology Association in 2010 shows consumers have a favorable impression of the quality of foreign brand condoms.

Condoms with trendy packaging attract young consumers in Wuhan, captial of Central China's Hubei province. Shepherd Zhou / for China Daily

In Beijing, for example, 73 percent of consumers prefer them when buying condoms.

In a sign of Chinese preference for foreign brands, a Chinese man sued a condom maker in September for stating its product was a foreign brand. The man claimed the condom was made by a Chinese company. No decision has yet been handed down in the case.

Chen Fang, a senior researcher with the National Population and Family Planning Commission, says many people prefer foreign brands because of their interesting designs on packages.

"There are no fun characteristics on the packaging of Chinese condoms even though they are high quality products," Chen says.

Foreign brands also link up with retail chains such as Watsons and 7-Eleven, as well as employ sales assistants to promote their products.

By comparison, condoms made by Chinese companies are generally found at pharmacies or e-commerce websites.

Jissbon, owned by Ansell Limited, sold 400 million condoms in China last year and has faith in the market potential of lower-tier cities.

"We are already present and focused on building our profile and business in third-tier cities, as more Chinese consumers there have high aspirations for luxury and premium condom brands," says Peter McCann, sales and marketing director of Asia-Pacific region, sexual health and well-being global business unit of Ansell Limited.

"The economic development phase of next-tier cities in China is no different to similar regions in Europe or the US that have been through in years past. The pace of evolution and development in China means the gap between the major urban centers and lower-tier regions is closing faster."

McCann says Jissbon will continue economic and consumer sophistication in second- and third-tier cities, such as introducing new materials, personalities, brand positioning, pricing, packaging, adjacencies and routes to those markets.

He predicts the condom per capita usage in China will grow closer to that of more advanced Western economies in the next five years.

The Internet also provides new opportunity for the condom business for Jissbon, especially in smaller cities, thanks to China's increasingly mature e-commerce market.

"We have a specific plan to develop online services aimed at third- and even fourth-tier cities," says Tang Xiangyang, CEO of Jissbon.

The company has cooperated with Taobao, a leading e-commerce platform, to develop its online condom business and is planning to establish its own platform this year.

Domestic condom makers also say smaller cities have big potential.

Hu Zhiqiang, general manager of Guilin HBM Healthcares Inc, says many third-tier cities in South China sell more Chinese brand condoms during major festivals, because migrant workers and university students return home.

"We sent more than 110 sales agents to various drugstores, retail stores, universities and supermarkets to popularize our product in cities

in Sichuan, Hunan, Hubei and Jiangxi provinces in January of this year," Hu says. "We also offer attractive bonus to our best-selling agents."

Hu says it would be extremely difficult to sell condoms in China's rural areas as the government has been providing free condoms to counties and villages for decades.

China began giving away condoms as a way of controlling population growth and sexually transmitted diseases in the early 1970s.

Last year, the government bought 2.2 billion condoms from domestic manufacturers, with most given to people in counties and countryside, the Ministry of Health says.

"Thus, domestic condom makers are not in a hurry to compete with their foreign rivals in China, as they don't need to seek the buyers by themselves," Hu says.

Gu Baochang, a professor from the Institute of Population Research at Beijing's Renmin University of China, says condom use in China is still low and more health education is needed.