Who continues using the diaphragm and who doesn't: implications for the acceptability of female-controlled HIV prevention methods.
OBJECTIVE
This study examines the acceptability of the diaphragm with the aim of facilitating the development of female-controlled human immunodeficiency virus (HIV) prevention methods. More specifically, we assess associations between being a current (vs. former) diaphragm user and characteristics that are hypothesized to influence the acceptability of contraceptive methods; and explore reasons for discontinuing use of the diaphragm among former diaphragm users.


METHODS
The study involved a cross-sectional telephone survey with women who were members of a nonprofit health maintenance organization and who were either a current (n = 215) or former (n = 172) diaphragm user.


METHODS
Participants were interviewed about the importance of contraceptive attributes; perceptions for the diaphragm; diaphragm use self-efficacy; perceived risk of and motivation to avoid pregnancy, HIV, and other sexually transmitted infections; and demographic characteristics, sexual, and contraceptive behavior.


RESULTS
The likelihood of being a current diaphragm user (vs. former) increased with age, greater confidence in being able to use the diaphragm, greater perceived risk of pregnancy and more positive perceptions of the diaphragm. Women who valued attributes of hormonal contraceptives were less likely to be current users. Former diaphragm users reported that the following reasons were moderately to extremely important in their decision to stop using the diaphragm: difficulty inserting or removing the diaphragm (50.8%), dislike of leaving the diaphragm inside the vagina (46.8%), and wanting a more effective method for preventing pregnancy (44.2%).


CONCLUSIONS
The findings suggest that specific characteristics of a product influence continued use and have implications for improving the acceptability of existing and new female-controlled HIV prevention methods.
Center for the Study of Women in Society, University of Oregon, Eugene, Oregon 97403, USA. mharvey@oregon.uoregon.edu
S Marie
SM
Harvey
Sheryl Thorburn
ST
Bird
Julie E
JE
Maher
Linda J
LJ
Beckman
D000328:Adult; D001294:Attitude to Health; D003268:Contraception Behavior / Q000523:psychology*; D003274:Contraceptive Devices, Female; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D011795:Surveys and Questionnaires; D014481:United States; D016387:Women's Health