Barrier contraceptive method acceptability and choice are not reliable indicators of use.
BACKGROUND
The need for safe and effective female-controlled methods that protect against sexually transmitted pathogens is widely recognized. Product effectiveness is inextricably bound to use, and, therefore, the needs and preferences of potential consumers must be considered. The degree to which measures of acceptability correlate with actual barrier method use remains unexamined.


OBJECTIVE
The goal was to evaluate associations between measures of acceptability and use of existing over-the-counter barrier methods.


METHODS
In the San Francisco Bay Area, 510 females aged 15 to 30 years were recruited from reproductive health clinics for this longitudinal study.


RESULTS
Neither hypothetical acceptability nor product choice predicted use. Fewer than 50% of participants who chose a female-controlled method used it. Similarly, method satisfaction was not associated with use (14.3-51.4% of satisfied users used the method again). However, dissatisfaction was predictive of low levels of subsequent use (0-15.3% used the method again). Male condoms were used despite dissatisfaction.


CONCLUSIONS
The lack of association among assessments of acceptability, choice, satisfaction, and use suggests a need to reframe how product acceptability is evaluated in prevention research so it is more predictive of method use.
Minnis
Alexandra M
AM
Center for Reproductive Health Research & Policy, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco 94105, USA. aminnis@psg.ucsf.edu
Shiboski
Stephen C
SC
Padian
Nancy S
NS
D000293:Adolescent; D000328:Adult; D002755:Choice Behavior; D019111:Single-Use Internal Condom / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000379:methods*; D011446:Prospective Studies; D012495:San Francisco / Q000453:epidemiology; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*
D003271:Contraceptive Agents, Female