Progesterone vaginal ring: Results of a three-country acceptability study

RamaRao, Saumya; Clark, Heather; Rajamani, Deepa; Ishaku, Salisu Mohammed; Mane, Babacar; Obare, Francis; Birungi, Harriet; Diop, Nafissatou; Liambila, Wilson; Mbow, Fatou; Undie, Chi-Chi; Unumeri, Godwin; Townsend, John

doi:10.31899/rh9.1063

Cited by 5 publications

(16 citation statements)

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“…Existing literature on progesterone acceptability is limited to contraception 14 , 15 and luteal support, 16 and generally demonstrate a high degree of acceptability. In a study based in Kenya, Nigeria, and Senegal, 14 98% of women reported satisfaction after 6-month use of a progesterone vaginal ring used for contraceptive benefits. One study 16 on luteal support found greater patient satisfaction with vaginal over intramuscular progesterone.…”

Section: Introductionmentioning

confidence: 99%

Perceived acceptability of progesterone to prevent preterm births and low birth weight among HIV-infected and HIV-uninfected Zambian pregnant women

Wong¹,

Kanga²,

Dogra³

et al. 2017

IJWH

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IntroductionIntramuscular and vaginal progesterone are recommended for prevention of preterm labor (PTL) in women with risk factors. Studies are emerging to indicate that HIV-infected women on combination antiretroviral therapy (cART) are at risk of PTL and low birth weight (LBW), and may benefit from supplemental progesterone. This study aims to determine the perceived acceptability of various modes of progesterone supplementation to prevent PTL and LBW in HIV-infected and HIV-uninfected women.MethodsHIV-infected and HIV-uninfected women were recruited in Lusaka, Zambia. The participants completed a questionnaire to assess their willingness to take oral, vaginal, or intramuscular progesterone supplementation for preventing PTL and LBW, preferred modes of supplementation, and concern for PTL and LBW.ResultsThe study questionnaire was completed by 147 participants. Of the participants, 98.6% would consider using a medication to help prevent PTL and LBW, of whom 97.9% would consider using an oral form of progesterone. In addition, 83.3% and 84.0% of women would consider intramuscular and vaginal (gel or tablet) administration of progesterone respectively. Between intramuscular and vaginal modes of progesterone, 60.5% of participants (n=147) preferred intramuscular progesterone, while 39.5% preferred vaginal progesterone. There was no difference in preference between HIV-infected (n=70) and HIV-uninfected (n=77) women.Conclusions/implicationsPregnant Zambian women demonstrated a high degree of acceptance for all modes of progesterone supplementation for the prevention of PTL and LBW. Women preferred intramuscular over vaginal supplementation. Progesterone supplementation can be considered a feasible intervention for preventing PTL and LBW in both HIV-infected and HIV-uninfected pregnant Zambian women.

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Section: Introductionmentioning

confidence: 99%

Perceived acceptability of progesterone to prevent preterm births and low birth weight among HIV-infected and HIV-uninfected Zambian pregnant women

Wong¹,

Kanga²,

Dogra³

et al. 2017

IJWH

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“…On the other hand, two studies reported that the previous use of tampons did not seem to influence satisfaction or successful ring use of CVR (13,51). A number of studies reported spontaneous expulsions rates ranging from less than 2% (14,16) to 5-20% (20,35,45,50). A study in Switzerland showed that 17.5% of adverse events were ring related, such as feeling the ring, vaginal discomfort, vaginal expulsions (30).…”

Section: Nuvaring ®mentioning

confidence: 99%

“…Acceptability of the progesterone vaginal ring was rated high including ease to insert/ remove/reinsert in African and Latin American settings and perceptions positively improved between the time the ring was first seen and the time it was used (35,40) (Table 3). Perceptions of the ring's size or texture were reported of more importance than its color at baseline in African settings (35). In Latin America, 5-30 % of women reported negative experiences (vaginal symptoms-excessive discharge or expulsion) (40) while in African settings expulsion reported rate was 5%.…”

Section: Nuvaring ®mentioning

confidence: 99%

Acceptability and satisfaction of contraceptive vaginal rings in clinical studies: a systematic review and narrative synthesis

Delvaux

Jespers

Beňová

et al. 2021

Preprint

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Introduction Acceptability of and satisfaction with contraceptive methods are paramount for uptake and continuation. In the current context of multipurpose prevention of pregnancy and sexually transmitted diseases /HIV development, it is critical to have a better understanding of acceptability of and satisfaction with the contraceptive vaginal ring (CVR), including sexual satisfaction. The objective of this study was to review the evidence about CVRs acceptability, and users general and sexual satisfaction. Methods We searched PubMed, CINAHL and Web of Science (until December 31th, 2020) and selected original studies documenting actual use of hormonal CVR and explicitly addressing any of the three outcomes. Main Results Of a total of 1129 records screened, 46 studies were included. Most studies (n=43, 93%) were prospective, conducted in high-income settings (n=35) and reported on NuvaRing use (n=31). Overall, 27 (59%) studies included a comparison group, 38 (82%) used exclusively quantitative questionnaires, with qualitative only (n=4, 9%) or mixed methods (n=4, 9%) studies being less common. Ease of CVR insertion/removal/reinsertion was high in all setting and improved with time of use, with qualitative studies supporting these findings. When reported, results on continuation of use were mixed and ring-related events were associated with discontinuation. Among NuvaRing studies, general satisfaction (being satisfied or very satisfied) was between 80 and 90% and tended to mirror continuation. Sexual satisfaction was less commonly reported and results were mixed. Overall, limited information was provided on actual CVR experiences of women (and men) and cultural norms that may affect sexuality and CVR use. Conclusion Positive aspects of acceptability of and satisfaction with CVRs were reported but continuation rates and ring-related events deserve further study. More information is needed on actual experiences of women using CVRs, relationship aspects, male partner opinions, and contextual norms to better understand the acceptability of and satisfaction with CVRs.

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“…Both quantitative and qualitative data were collected and the results of the quantitative data analysis have been published. 10,11 In the quantitative study, a total of 247 women were screened across all country sites. Of these, 76% (n=189) met the eligibility criteria and provided informed consent to participate in the study.…”

Section: Introductionmentioning

confidence: 99%

“…A total of 28 women in this larger study discontinued PVR use. 11 They did so early on (within the first month of use) and for various reasons, including discomfort (9), inadvertent expulsion of the ring (9), slippage sensations (5), wanting a different method (2), and spousal objection to the use of the ring (3). This larger, quantitative study also involved the collection of data from the first 58-60 women in each country who visited the study sites and chose a contraceptive other than the PVR (n=178).…”

Section: Introductionmentioning

confidence: 99%

<p>Choosing and Using the Progesterone Vaginal Ring: Women’s Lived Experiences in Three African Cities</p>

Undie¹,

RamaRao²,

Mbow³

2020

PPA

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This study explored experiences of selecting and utilizing a newly introduced contraceptive-the progesterone vaginal ring (PVR)-among women seeking a contraceptive method in 3 African capital cities (Abuja, Nairobi, and Senegal). The study explored women's perceptions of, and lived experiences with, using the new product to better understand their reception of a new contraceptive. This understanding will help inform the design of programs to support women in their adoption and continued use of the PVR and other new contraceptives. Patients and Methods: This longitudinal, qualitative study drew on an interpretive phenomenological approach, involving multiple in-depth interviews (IDIs) with 9 study participants over a 6-month period. Participants involved in the study were postpartum women seeking contraceptive services at participating clinics. A total of 25 IDIs were conducted, and a detailed "within-case" and "cross-case" analysis of participants' accounts was carried out to identify similar and dissimilar themes along descriptive, linguistic, and conceptual lines. Results: Four overarching themes emerged from the analysis. These themes circulated around the unconventionality of the PVR, which heightened its desirability among participants; the sense of comfort that women gained from opting to use the PVR over other FP methods; narratives of consideration that centered on women's partners, and that were important for ensuring the sustainability of women's PVR use; and the conundrums that women grappled with as they prepared to disengage from the PVR after two cycles of use. Conclusion: The PVR is an acceptable contraceptive method to postpartum women in urban African settings. However, prior to its introduction into new country contexts, formative data on women's perceptions of, and reactions to, the product need to inform country preparation processes. Such information would be useful for tailoring counseling around this contraceptive, as well as for product marketing and robust uptake of the method.

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Progesterone vaginal ring: Results of a three-country acceptability study

Cited by 5 publications

References 4 publications

Perceived acceptability of progesterone to prevent preterm births and low birth weight among HIV-infected and HIV-uninfected Zambian pregnant women

Perceived acceptability of progesterone to prevent preterm births and low birth weight among HIV-infected and HIV-uninfected Zambian pregnant women

Acceptability and satisfaction of contraceptive vaginal rings in clinical studies: a systematic review and narrative synthesis

<p>Choosing and Using the Progesterone Vaginal Ring: Women’s Lived Experiences in Three African Cities</p>

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