title: The importance of discreet use of the diaphragm to Zimbabwean women and their partners.
abstract: We conducted a 6-month acceptability study of diaphragms as a potential HIV/STI prevention method among Zimbabwean women. We examined partner involvement in diaphragm use, and importance of discreet use (use without partner awareness). Of the 181 women who completed the study, 45% said discreet use was "very or extremely important" and in multivariate logistic regression, women were more likely to value discretion if their partners: had other partners; drank alcohol; or were believed to prefer condoms to diaphragms. Qualitative data confirmed these findings. Both women and their partners reported that diaphragms can be used discreetly and saw this as advantageous, for both sexual pleasure and female control. However, many were concerned that use without partner approval could lead to marital problems. Discreet use should be considered in development of barrier methods and in diaphragm promotion, if proven effective against HIV/STI.
authors.affiliation: UZ-UCSF Collaborative Research Programme in Women's Health, Harare, Zimbabwe. mkang@globalhealth.ucsf.edu
authors.forename: Mi-Suk
authors.initials: MS
authors.lastname: Kang
authors.forename: Jessica
authors.initials: J
authors.lastname: Buck
authors.forename: Nancy
authors.initials: N
authors.lastname: Padian
authors.forename: Sam F
authors.initials: SF
authors.lastname: Posner
authors.forename: Gertrude
authors.initials: G
authors.lastname: Khumalo-Sakutukwa
authors.forename: Ariane
authors.initials: A
authors.lastname: van der Straten
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking; D003268:Contraception Behavior; D003274:Contraceptive Devices, Female / Q000706:statistics & numerical data*; D030881:Disclosure; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D012725:Sexual Behavior; D012747:Sexual Partners; D015030:Zimbabwe