Acceptability of an existing, female-controlled contraceptive method that could potentially protect against HIV: a comparison of diaphragm users and other method users.
OBJECTIVE
The diaphragm, an internal barrier contraceptive device, is a candidate for a female-controlled method for preventing human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). This study's objective was to examine how women who use the diaphragm differ from women using the pill and/or condoms with respect to factors hypothesized to influence the acceptability of contraceptive methods. Our goal was to increase understanding of who finds the diaphragm acceptable and why.


METHODS
We conducted a cross-sectional telephone survey with selected female members of a managed care organization. For this analysis, we limited the sample to 585 women currently using the diaphragm (n = 196), pill (n = 200), condoms (n = 132), or pill and condoms (n = 57). We conducted bivariate analyses and multinomial logistic regression analyses to assess the associations between selected characteristics and diaphragm use.


RESULTS
Diaphragm use was significantly associated with several variables. Of particular interest, placing less importance on hormonal method characteristics was significantly associated with diaphragm use (versus use of the pill, condoms, or both). Placing more importance on barrier method attributes was significantly associated with diaphragm use (versus pill use, alone or with condoms). In addition, lower condom use self-efficacy was significantly associated with diaphragm use (versus condom use, alone or with pill). Lack of motivation to avoid HIV/STIs was significantly associated with using the diaphragm versus condoms (only).


CONCLUSIONS
These results have important implications for future research, interventions, counseling strategies for providers, and product development. Our findings suggest that if the diaphragm protects against HIV, it could be a desirable option for some women.
Bird
Sheryl Thorburn
ST
Department of Public Health, Oregon State University, Corvallis, Oregon 97331, USA. Sheryl.Bird@oregonstate.edu
Harvey
S Marie
SM
Maher
Julie E
JE
Beckman
Linda J
LJ
D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000706:statistics & numerical data*; D003274:Contraceptive Devices, Female / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D019538:Health Care Surveys; D006801:Humans; D008329:Managed Care Programs; D008875:Middle Aged; D009922:Oregon / Q000453:epidemiology; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D016387:Women's Health