title: Acceptability and adherence of a candidate microbicide gel among high-risk women in Africa and India.
abstract: Vaginal microbicides currently under development are substances that may prevent the transmission of HIV. Qualitative, in-depth post-trial interview data from a Phase III clinical trial of 6% Cellulose Sulfate microbicide gel in two sites in Africa (Uganda and Benin) and two in India (Chennai and Bagalkot) were examined in order to better understand factors that influence microbicide acceptability and adherence in a clinical trial setting. Women found the gel relatively easy to use with partners with whom there were no expectations of fidelity, in situations where they had access to private space and at times when they were expecting to engage in sexual intercourse. Adherence to gel seemed significantly more difficult with primary partners due to decreased perceptions of risk, inconvenience or fear of partner disapproval. Findings suggest that women in a variety of settings may find a microbicide gel to be highly acceptable for its lubricant qualities and protective benefits but that adherence and consistent use may depend greatly on contextual and partner-related factors. These findings have important implications for future trial designs, predicting determinants of microbicide use and acceptability and marketing and educational efforts should a safe and efficacious microbicide be found.
authors.affiliation: Family Health International, Research Triangle Park, North Carolina, USA. egreene@fhi.org
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Greene
authors.forename: Georges
authors.initials: G
authors.lastname: Batona
authors.forename: Jyoti
authors.initials: J
authors.lastname: Hallad
authors.forename: Sethulakshmi
authors.initials: S
authors.lastname: Johnson
authors.forename: Stella
authors.initials: S
authors.lastname: Neema
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Tolley
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001541:Benin; D003075:Coitus; D004311:Double-Blind Method; D005260:Female; D005782:Gels / Q000008:administration & dosage / Q000627:therapeutic use*; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D015438:Health Behavior; D006801:Humans; D007194:India; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D036301:Qualitative Research; D018570:Risk Assessment; D012307:Risk Factors; D015229:Sexually Transmitted Diseases, Viral / Q000517:prevention & control / Q000635:transmission; D014454:Uganda; D014621:Vagina / Q000187:drug effects / Q000382:microbiology*; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents; D005782:Gels