The role of men in women's acceptance of an intravaginal gel in a randomized clinical trial in Blantyre, Malawi: a qualitative and quantitative analysis

Salter, Megan L.; Go, Vivian F.; Celentano, David D.; Diener‐West, Marie; Nkhoma, Chiwawa; Kumwenda, Newton; Taha, Taha E.

doi:10.1080/09540120701742300

Cited by 17 publications

(8 citation statements)

References 25 publications

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“…While here, more than half the participants thought men wouldn't like to have sex if gel made the vagina "wet", in user-based microbicide and diaphragm studies, gel in moderate amount was generally well accepted and liked by women and their male partners. [43][44][45] Most participants favoured CB methods' attributes associated with female-control and non-interference with sex, which is consistent with results of other studies of female-controlled methods of HIV and pregnancy prevention. [46][47][48] Overall attitudes towards CB were positive, and few potential barriers to use were noted.…”

Section: Discussionsupporting

confidence: 87%

Feasibility and potential acceptability of three cervical barriers among vulnerable young women in Zimbabwe

Straten

Sahin-Hodoglugil²,

Clouse³

et al. 2010

j fam plann reprod health care

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Background We explored the potential acceptability of three cervical barriers (CB) (Ortho All-Flex ® diaphragm, SILCS ® diaphragm, FemCap TM cervical cap) among sexually experienced Zimbabwean young women.Methods Forty-five young women (aged 16-21 years) received an individual CB educational session. Participants were then randomly assigned to one of the three CBs in a 1:1:1 ratio, and practised insertion and removal of their device at the clinic. Next, participants were interviewed on their practice experiences, and their post-practice attitudes towards CB.Results All 45 young women were willing and able to insert their assigned device. The majority reported "easy" insertion and removal and 93% "liked" the device they tried. All showed interest in participating in future CB studies: when asked which device they would like to try 13 IntroductionYoung women are the most vulnerable population for heterosexual acquisition of HIV. 1 Adolescents are more susceptible than adult women, likely because an immature genital tract increases their susceptibility to physical trauma and sexually transmitted infections (STIs). 2 Furthermore, gender inequalities in sexual relationships often leave young women unable to negotiate condom use. [3][4][5] In Zimbabwe, 25% of females aged 15-24 years are infected with HIV compared to 11% of males in that age group. 6 Additionally, with 40% of Zimbabwean women aged 15-49 years being non-current users of modern family planning methods, there remains a significant unmet need for contraception, particularly among young sexually active women (63% non-current users among 15-19-yearolds), as indicated by estimates that up to 60 000-80 000 illegal and unsafe abortions occur each year. 6,7 Male condoms are the only currently available method known to provide dual protection by preventing pregnancy in the future, over half (58%) chose SILCS, regardless of the device they had tried. The majority felt comfortable touching their genitals to insert/remove the CB and most participants favoured methods' attributes associated with female-control and non-interference with sex. Over half the participants said they would prefer to use a CB continuously compared to episodic use. Two-thirds of them expressed interest in CB for dual protection. ConclusionThe concept of CB, and initial insertion experience, were well accepted in this selected, small group of Zimbabwean young women. Evaluating CB in larger studies seems feasible in this population. and STIs including HIV; although not proven in clinical trials, female condoms are believed to provide similar protection. 8,9 While female condoms are woman-initiated, they still require male partner co-operation, as they are noticeable during sex. Cervical barriers (CB), including the diaphragm, are also woman-initiated methods, and act by protecting the cervix from exposure to ejaculate. The diaphragm is one of the oldest contraceptives, although it has lost much of its popularity with the advent of hormonal contraceptives. 10 CB might be of interest to...

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Section: Discussionsupporting

confidence: 87%

Feasibility and potential acceptability of three cervical barriers among vulnerable young women in Zimbabwe

Straten

Sahin-Hodoglugil²,

Clouse³

et al. 2010

j fam plann reprod health care

View full text Add to dashboard Cite

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“…Influences on intravaginal and menstrual practices thus form part of the range of individual, partner/interpersonal, cultural and environmental factors which may impact on satisfaction with a microbicide product and willingness to use it [8, 9, 16–18]. It has been noted that inadequate adherence (correct and consistent use) may have affected the results of randomised controlled trials of some HIV prevention interventions including microbicides, and that there is a need for research to reveal influences on adherence [12, 19–22].…”

Section: Introductionmentioning

confidence: 99%

Intravaginal and Menstrual Practices among Women Working in Food and Recreational Facilities in Mwanza, Tanzania: Implications for Microbicide Trials

et al. 2010

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Intravaginal and menstrual practices may potentially influence results of trials of microbicides for HIV prevention through effects on the vaginal environment and on adherence to microbicide and placebo products. As part of the feasibility study for the Microbicides Development Programme Phase 3 trial of a vaginal microbicide in Mwanza, a variety of quantitative and qualitative methods were used to describe these practices, associations with behaviour and underlying social norms among women working in food and recreational facilities. Intravaginal cleansing by inserting fingers and either water alone or soap and water was thought necessary to remove “uchafu” (dirt), referring to vaginal secretions, including menstrual blood and post-coital discharge. Vaginal cleansing was carried out within 2 hours after 45% of sex acts. Sexual enhancement practices were less common. Intravaginal and menstrual practices and associated behaviours and demographic factors should be measured and monitored throughout microbicide trials to enable analyses of their impacts on microbicide effectiveness.

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“…Among women who were reported to find microbicide acceptable in three sites in Africa and India, concerns about covert use were tied to issues of partner acceptability and preference, wetting effect, faithfulness and questionable health status [33] . Again, several studies have documented fear of abuse and other serious consequences especially in patriarchal societies where women generally have low assertive skills to negotiate safe sex [33-35]. The message of discreet use is therefore unlikely to be socially acceptable to women in formal and relatively stable relationships.…”

Section: Discussionmentioning

confidence: 99%

An assessment of the likely acceptability of vaginal microbicides for HIV prevention among women in rural Ghana

et al. 2012

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BackgroundThe findings of the CAPRISA tenofovir studies have raised expectations that soon an approved microbicide would be available. However it is in only a limited number of countries in sub-Saharan Africa that the acceptability of microbicides has been evaluated. We conducted a study to assess the acceptability of vaginal microbicides among women in rural Ghana.MethodsThe study employs a mixed method design, using cross-sectional survey and focus group discussions to further understand issues related to awareness and attitudes towards microbicide development, acceptability and perceived partner attitudes among pregnant women attending antenatal clinic in two health facilities in the Kintampo North municipality of Ghana. We used logistic regression to identify possible predictors of microbicide acceptability among the women surveyed.ResultsAlthough only 2% of the 504 women were aware of the development of microbicides, 95% were willing to use one when it became available. The cost of a microbicide that will be considered affordable to 50% of women was US$0.75. Although there were concerns about possible wetting effect, gel or creams were the most preferred (68% of women) formulation. Although 71% thought their partners will find microbicide acceptable, apprehensions about the feasibility of and consequences of failed discreet use were evident. 49% of women were concerned about possible negative effect of microbicide on sexual pleasure. Perceived partner acceptability (O.R. =17.7; 95%C.I. 5.03-62.5) and possibility of discreet use (O.R. =8.9 95%C.I. 2.63-30.13) were the important predictors of microbicide acceptability.ConclusionAchieving microbicide acceptability among male partners should be made a part of the promotive interventions for ensuring effective use among women in rural Ghana.

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The role of men in women's acceptance of an intravaginal gel in a randomized clinical trial in Blantyre, Malawi: a qualitative and quantitative analysis

Cited by 17 publications

References 25 publications

Feasibility and potential acceptability of three cervical barriers among vulnerable young women in Zimbabwe

Feasibility and potential acceptability of three cervical barriers among vulnerable young women in Zimbabwe

Intravaginal and Menstrual Practices among Women Working in Food and Recreational Facilities in Mwanza, Tanzania: Implications for Microbicide Trials

An assessment of the likely acceptability of vaginal microbicides for HIV prevention among women in rural Ghana

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