title: Acceptability and use of the diaphragm and Replens lubricant gel for HIV prevention in Southern Africa.
abstract: The acceptability and use of the diaphragm and lubricant gel were assessed as part of a large randomized controlled trial to determine the effectiveness of the methods in women's HIV acquisition. 2,452 intervention-arm women were enrolled at five Southern African clinics and followed quarterly for 12-24 months. Acceptability and use data were collected by face-to-face interviews at Month 3 and Exit. Participants were "very comfortable" with the physical mechanics of diaphragm use throughout the trial, and approval of the gel consistency, quantity and the applicator was high. At Exit, consistent disclosure of use (AOR 1.97, 95% CI: 1.10-3.55); an overall high diaphragm rating (AOR 1.84, 95% CI: 1.45-2.34) and perception of partner approval (AOR 1.75, 95% CI: 1.35-2.26) were the most significant acceptability factors independently associated with consistent use. Despite being female-initiated, disclosure of use to male partners and his perceived approval of the products were factors significantly associated with their consistent use.
authors.affiliation: Women's Global Health Imperative, RTI International, San Francisco Project Office, 114 Sansome Street, Suite 500, San Francisco, CA 94104, USA. emontgomery@rti.org
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Montgomery
authors.forename: Helen
authors.initials: H
authors.lastname: Cheng
authors.forename: Ariane
authors.initials: A
authors.lastname: van der Straten
authors.forename: Agnes C
authors.initials: AC
authors.lastname: Chidanyika
authors.forename: Naomi
authors.initials: N
authors.lastname: Lince
authors.forename: Kelly
authors.initials: K
authors.lastname: Blanchard
authors.forename: Gita
authors.initials: G
authors.lastname: Ramjee
authors.forename: Busisiwe
authors.initials: B
authors.lastname: Nkala
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Padian
mesh_terms: D000328:Adult; D003274:Contraceptive Devices, Female / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007407:Interviews as Topic; D008055:Lipids / Q000627:therapeutic use; D016015:Logistic Models; D008153:Lubrication; D008297:Male; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012309:Risk-Taking; D012725:Sexual Behavior; D013019:South Africa / Q000453:epidemiology; D016896:Treatment Outcome; D014622:Vaginal Creams, Foams, and Jellies / Q000627:therapeutic use*; D055815:Young Adult; D015030:Zimbabwe / Q000453:epidemiology
chemical_list: D008055:Lipids; C085472:Replens; D014622:Vaginal Creams, Foams, and Jellies