title: Predictors of diaphragm use as a potential sexually transmitted disease/HIV prevention method in Zimbabwe.
abstract: BACKGROUND
  Women who are the most vulnerable to sexually transmitted diseases/HIV are often unable to consistently use condoms. One potential alternative method currently under investigation is the diaphragm.
  
  
  OBJECTIVE
  The goals of this study were to assess diaphragm uptake and use over time in Zimbabwe and to identify factors associated with self-reported consistent diaphragm use.
  
  
  METHODS
  Women attending family planning clinics who were inconsistent condom users received a diaphragm intervention and were followed for 6 months.
  
  
  RESULTS
  Of the 186 participants, 99% ever reported using the diaphragm, and, at study exit, 96% had used it in the previous 2 months. Consistent diaphragm use since the previous visit was reported by 13% to 16% of the women, and in multivariate regression analysis, it was significantly associated with never using condoms (adjusted odds ratio, 24.08; 95% confidence interval, 6.71-86.34). Other factors included discreet use, preferring diaphragms to condoms, timing of insertion, domestic violence, and contraception.
  
  
  CONCLUSIONS
  Diaphragms were well accepted among women at risk for sexually transmitted diseases/HIV.
authors.affiliation: Center for Reproductive Health Research & Policy, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, 74 New Montgomery Street, Suite 400, San Francisco, CA 94105, USA. avdstraten@psg.ucsf.edu
authors.forename: Ariane
authors.initials: A
authors.lastname: van der Straten
authors.forename: Mi Suk
authors.initials: MS
authors.lastname: Kang
authors.forename: Samuel F
authors.initials: SF
authors.lastname: Posner
authors.forename: Mavis
authors.initials: M
authors.lastname: Kamba
authors.forename: Tsungai
authors.initials: T
authors.lastname: Chipato
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Padian
mesh_terms: D000293:Adolescent; D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data*; D003274:Contraceptive Devices, Female / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D015030:Zimbabwe / Q000453:epidemiology