The dapivirine vaginal ring from the perspective of married men in Uganda

Abstract

Men play a key role in influencing uptake of women's health products such as female condoms and vaginal microbicides, used for family planning and HIV prevention. We explored men's perceptions towards the dapivirine vaginal ring (DVR), a vaginal microbicide, in Kalungu District, rural Southwestern Uganda. Between June and July 2018, we conducted in-depth interviews with ten partners of women participating in the DREAM Study, a Phase IIIb open label extension trial of the DVR. Data were analyzed thematically, drawing on the socio-ecological model theoretical framework. Influencing factors like individual and interpersonal characteristics, perception of HIV risk, lack of knowledge about the DVR, misconceptions, and product characteristics acting at different levels (individual, societal and organizational) affected men's knowledge,attitudes and perceptions towards the DVR which in turn impacted on their willingness to allow their partners to use it. Above all, men wanted to be involved in the decisionmaking process about the use of the DVR. All the men were happy that there was a new HIV prevention option in the pipeline, and were not concerned about the degree of effectiveness saying it was better than nothing. The use of the DVR in an environment where men expect to make decisions about sex on behalf of women may affect its usage and success. Given this context, women may not always be able to independently choose to use it. If the DVR is approved and rolled out, increased sensitization of men about it will be critical to ensure its uptake.

Predictors of Loss to Follow-Up in an HIV Vaccine Preparedness Study in Masaka, Uganda

“…High LFTU among women may be attributed to competing responsibilities that commonly fall to women, such as caring for the sick, and childrearing [ 7 ]. Also, in our setting as in other areas in sub-Saharan Africa, retention of women may be affected by the fact that they have limited autonomy and are often disadvantaged economically [ 18 , 19 , 20 , 21 , 22 ]. For example a married woman often needs to obtain her partner’s permission to travel away from home as well as his financial support to cover travel expenses [ 18 , 19 ].…”