Willingness of clinicians to integrate microbicides into HIV prevention practices in southern Africa.
The first vaginal microbicide was recently proven effective in clinical trials. We assessed the willingness of clinicians to integrate microbicides into HIV prevention practices in Southern Africa, where women face elevated HIV risks. We conducted in-depth interviews (n = 60) and nationally representative surveys (n = 1,444) in South Africa and Zimbabwe with nurses and physicians. Over half of clinicians (58%) were aware of microbicides, with physicians far more likely than nurses to be familiar. Clinicians, including those in rural areas, were generally willing to discuss microbicides, a female-initiated method less effective than the condom, particularly when condom use was unlikely (70%). Fewer would include microbicides while counseling adolescents (51%). Most clinicians (85%) thought their patients would use microbicides; greater clinician familiarity with microbicides was significant for support. Training for both nurses and physicians prior to introduction is critical, so they have sufficient knowledge and skills to offer a microbicide upon availability.
Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California-San Francisco, CA 94118, USA. harperc@obgyn.ucsf.edu
Cynthia C
CC
Harper
Kelsey
K
Holt
Taazadza
T
Nhemachena
Tsungai
T
Chipato
Gita
G
Ramjee
Laura
L
Stratton
Maya
M
Blum
Charles E
CE
McCulloch
Sibongile
S
Mgweba
Kelly
K
Blanchard
D000282:Administration, Intravaginal; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D001291:Attitude of Health Personnel; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D012424:Rural Population; D013019:South Africa; D014505:Urban Population; D055815:Young Adult; D015030:Zimbabwe
D000891:Anti-Infective Agents, Local