The role of partnership dynamics in determining the acceptability of condoms and microbicides

Montgomery, Catherine M.; Lees, Shelley; Stadler, Jonathan; Morar, Neetha; Ssali, Agnes; Mwanza, Bupe Getrude; Mntambo, M.; Phillip, J; Watts, Charlotte; Pool, Robert

doi:10.1080/09540120701693974

Cited by 106 publications

(136 citation statements)

References 26 publications

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“…Similarly, access to HIV testing among males has been found to be poor in south-western Uganda due to stigma and lack of confidentiality (Bwambale et al, 2008). However, in a recent study, male spouse negotiations and decisions on use of microbicides for HIV prevention were useful, and provided opportunity for intimate communications, and building trust (Montgomery et al, 2008). Based on the results, recommendations have been made to provide information to people and facilitate decision making and appropriate responses for care seeking (Golooba-Mutebi & Tollman, 2007).…”

Section: Discussionmentioning

confidence: 99%

Barriers to Prevention of Mother-to-Child Transmission of Hiv Services in Uganda

et al. 2009

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Summary. Understanding care-seeking practices and barriers to prevention of mother-to-child transmission (PMTCT) of HIV is necessary in designing effective programmes to address the high disease burden due to HIV/AIDS in Uganda. This study explored perceptions, care-seeking practices and barriers to PMTCT among young and HIV-positive women. A household survey (10,706 women aged 14-49 years), twelve focus group discussions and 66 key informant interviews were carried out between January and April 2009 in Wakiso district, central Uganda. Results show that access to PMTCT services (family planning, HIV counselling and testing and delivery at health units) was poor. Decision making was an important factor in accessing PMTCT services. Socioeconomic factors (wealth quintile, age, education level) and institutional practices also influenced access to PMTCT. Overall, having had an HIV test was highest when both men and women made decisions together or when women were empowered to make their own decisions. This was significant across wealth quintiles (p=0.0001), age groups (p=0.0001) and education levels (p=0.0001). The least level of HIV testing was when men made decisions for their spouses; and this was the case with family planning and deliveries at health units. Other barriers to PMTCT were fear of women and male spouses to have an HIV test and the perception that HIV testing is compulsory in antenatal clinics. In conclusion, to increase access to PMTCT among women, especially the young, poor and least educated, there is a need to empower them to make decisions on health seeking, and also to empower men to support their spouses to make good decisions. Other barriers like fear of having an HIV test should be addressed through appropriate counselling of clients.

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Section: Discussionmentioning

confidence: 99%

Barriers to Prevention of Mother-to-Child Transmission of Hiv Services in Uganda

et al. 2009

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“…43,73,74,79,113,115,116 For these reasons, condoms are not only considered unnecessary, but are also seen as damaging in a relationship built on trust, most especially in marriage. 32,76,80,[114][115][116][117] In Chimbiri's study in Malawi, for example, condoms were referred to as 'an intruder into the domestic space.' 77 This is even the case for serodiscordant couples.…”

Section: Noncommercial Relationshipsmentioning

confidence: 99%

Condoms in sub-Saharan Africa

Maticka‐Tyndale¹

2012

Sex. Health

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Abstract. Sub-Saharan Africa (SSA) is the region with the world's highest rates of HIV and other sexually transmissible infections (STIs), yet numerous studies show that condom use is generally rare. This suggests a need for a better understanding of how condoms fit within sexual practices and relationships in SSA. This paper seeks to address this need by reviewing research published between the late 1980s and 2011 on use and factors influencing use of male condoms in SSA. What is evident from this research is that condom use involves complex social and interpersonal dynamics, with structural and cultural conditions exerting an influence through framing social cognitions and setting boundaries on autonomy that make the apparently irrational choice of eschewing condoms a rational decision. The influences of poverty; relationships with parents, peers and partners; limited, insufficient or absent information especially in rural areas and among men who have sex with men; gender and sexual norms, and the dynamics of gendered power; and beliefs and attitudes about HIV, condoms and sexuality all have been shown to work against condom use for a large proportion of Africa's people. However, promising results are shown in trends towards increased condom use among single women in numerous countries, increasing acceptance and use of condoms among some university students, successes in producing potentially sustainable condom use resulting from select interventions, and resistance to succumbing to the dominant gender-power dynamics and structural-cultural impediments that women in groups have mobilised.

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“…The influence of partners in decisions to use the gel has been reported by other studies (Doggett et al, 2015;Jones et al, 2008;Kelly et al, 2015;Koo et al, 2005;C. M. Montgomery et al, 2008;Moon et al, 2002;Veldhuijzen et al, 2006;Venables & Stadler, 2012;C.…”

Section: Discussionmentioning

confidence: 90%

“…Questions on why and how male partners have influence in microbicides acceptability have not been fully explored in the context of social constructs and practices of masculinity and gender (Coly & Gorbach, 2008;Domanska & Teitelman, 2012;Mantell et al, 2005). Some studies that have attempted to do so have limited their analysis to the level of the couple and in the context of sexual relationships, rather than the broader social norms on sexuality, hegemonic masculinity and gender (Kelly et al, 2015;Lanham et al, 2014; C. M. Montgomery et al, 2010; C. M. Montgomery et al, 2008;C. Woodsong et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…Woodsong et al, 2013). One prominent issue from these studies is the role male partners play in the use of vaginal microbicide (Doggett et al, 2015;Jones, Weiss, Chitalu, Bwalya, & Villar, 2008;Koo, Woodsong, Dalberth, Viswanathan, & Simons-Rudolph, 2005;Lanham et al, 2014; C. M. Montgomery et al, 2010; C. M. Montgomery et al, 2008;Moon, Khumalo-Sakutukwa, Heiman, Mbizvo, & Padian, 2002;Venables & Stadler, 2012;C. Woodsong & Alleman, 2008;Cynthia Woodsong & Holt, 2015; C. Woodsong et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

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The influence of social constructs of hegemonic masculinity and sexual behaviour on acceptability of vaginal microbicides in Zambia

Mweemba

Dixey

White

2017

Global Public Health

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Vaginal microbicides are heralded as a woman's HIV prevention method. This ethnographic study, conducted in a trial setting in Zambia, explored how the social construction of masculinity and sexual behaviour influenced the acceptability of vaginal microbicides from the man's perspective. The data was generated from 18 In-depth Interviews (IDIs), and 8 Focus Group Discussions (FGDs). The data was analysed thematically. The study found that hegemonic masculinity influenced the use of gel use among women in multiple ways: decision to initiate gel use, autonomous use of the gel and consistent use of the gel. Men were seen as heads of households and decision makers who approved their partners' intentions to initiate gel use. Autonomous gel use by women was not supported because it challenged men's position in sexual matters and at family level. The socially accepted notion that men engaged in multiple sexual relationships also influenced women's decision to use the gel. Sustained gel use depended on the perceived effect of the gel on men's sexual desires, sexual performance, fertility, and sexual behaviour. This study suggests that acceptability of microbicides partially lies within the realm of men, with use constrained and dictated by cultural constructs and practice of masculinity and gender.

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The role of partnership dynamics in determining the acceptability of condoms and microbicides

Cited by 106 publications

References 26 publications

Barriers to Prevention of Mother-to-Child Transmission of Hiv Services in Uganda

Barriers to Prevention of Mother-to-Child Transmission of Hiv Services in Uganda

Condoms in sub-Saharan Africa

The influence of social constructs of hegemonic masculinity and sexual behaviour on acceptability of vaginal microbicides in Zambia

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