Health practices and vaginal microbicide acceptability among urban black women.
BACKGROUND
Intravaginal topical microbicides are being investigated for prevention of HIV transmission. Use of vaginal microbicides will constitute a new type of practice, occurring in the context of other vaginal practices related to contraception, hygiene, and self-care, which are affected by cultural norms and personal beliefs. Given the high rate of HIV infection among black women, research on practices and decision making relevant to microbicide acceptability is needed in this population.


METHODS
Twenty-three black women in New York City, aged 25-64, completed in-person semistructured interviews and self-administered questionnaires. Quantitative analyses examined vaginal practices and willingness to use microbicides. Qualitative analyses explored underlying decision-making processes involved in choices regarding vaginal practices and general healthcare.


RESULTS
Willingness to use vaginal products for HIV prevention was high, especially among more educated women. Safety was a major concern, and women were cautious about using vaginal products. Whereas some viewed synthetic products as having potentially harmful side effects, others perceived natural products as risky because of insufficient testing. Choices about vaginal practices were affected by assessments of risk and efficacy, prior experience, cultural background, and general approach to healthcare.


CONCLUSIONS
The majority of women in the sample expressed willingness to use a vaginal product for HIV prevention. Decision-making processes regarding vaginal practices were complex and were affected by social, cultural, and personal factors. Although specific preferences may vary, attitudes toward using a vaginal product are likely to be positive when side effects are minimal and the product is considered safe.
Reiff
Marian
M
The Richard and Hinda Rosenthal Center for Complementary and Alternative Medicine Department of Rehabilitation Medicine, College Physicians & Surgeons, Columbia University, New York, New York, USA. reiff82@gmail.com
Wade
Christine
C
Chao
Maria T
MT
Kronenberg
Fredi
F
Cushman
Linda F
LF
D000282:Administration, Intravaginal; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000704:Analysis of Variance; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002755:Choice Behavior; D000529:Complementary Therapies / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000208:ethnology / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009519:New York City; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology*; D011795:Surveys and Questionnaires; D014505:Urban Population
D000891:Anti-Infective Agents, Local
J Natl Med Assoc. 2003 Oct;95(10):943-50
14620706
Contraception. 2003 May;67(5):391-5
12742563
Med Anthropol Q. 1998 Sep;12(3):267-72
9746894
J Natl Med Assoc. 2005 Apr;97(4):535-45
15868773
Med Care. 2002 Apr;40(4):353-8
12021691
Int Fam Plan Perspect. 2004 Jun;30(2):94-8
15210408
Vital Health Stat 23. 2005 Dec;(25):1-160
16532609
Sex Transm Dis. 2003 Jul;30(7):556-61
12838083
J Womens Health (Larchmt). 2005 Jun;14(5):424-33
15989415
Indian J Med Res. 2006 Apr;123(4):547-52
16783046
Ethn Dis. 2004 Spring;14(2):189-97
15132203
Sex Transm Infect. 2007 Dec;83(7):505-8
18024709
Am J Public Health. 1990 Apr;80(4):460-2
2316768
J Altern Complement Med. 2001 Dec;7(6):659-66
11822614
Soc Sci Med. 2005 Jan;60(2):319-30
15522488
J Womens Health (Larchmt). 2007 Jan-Feb;16(1):102-13
17324101
Med Anthropol Q. 1998 Sep;12(3):319-40
9746897
J Soc Issues. 2005 Mar;61(1):67-93
21822334
Am J Public Health. 2006 Jul;96(7):1236-42
16735632
Soc Sci Med. 2000 Jul;51(2):251-64
10832572
J Urban Health. 2001 Dec;78(4):593-604
11796806
J Altern Complement Med. 2006 Oct;12(8):719-22
17034277
AIDS Behav. 2005 Mar;9(1):121-31
15812619
Indian J Med Res. 2006 Jun;123(6):719-22
16885590
J Womens Health (Larchmt). 2004 Nov;13(9):1048-65
15665661
Eur J Contracept Reprod Health Care. 2005 Dec;10(4):212-8
16448947
Am J Public Health. 2002 Nov;92(11):1832-40
12406817
J Womens Health (Larchmt). 2008 Jun;17(5):829-40
18537484
J Womens Health Gend Based Med. 2001 Mar;10(2):163-73
11268299
Altern Ther Health Med. 2003 Jul-Aug;9(4):50-6
12868252