title: How effective is effective enough? Opinions of potential end-users of microbicides from a rural South African community.
abstract: To assess the views of potential end-users of a microbicide in KwaZulu-Natal regarding the characteristics that would justify further development, three focus group discussions were conducted in 2009 with 23 local staff members working on a microbicide clinical trial, 20 former trial participants and 14 Community Advisory Board members not enrolled in the trial, in an area with high HIV incidence and low consistent condom use. All participants agreed on the need for additional HIV prevention options that are as effective as possible and can be used by women. The majority of respondents stated that even a highly acceptable HIV prevention option with protection as low as 30% would still be an important addition to condoms for women; that a partially protective microbicide would have to be introduced as part of the existing prevention messages in order to continue promoting condom use; that there should eventually be a choice between antiretroviral (ARV) and non-ARV-based microbicides and a choice of how and where to access microbicides. Respondents also felt it would be important to make plans for access to a microbicide that can offer protection, even if partial, rather than wait to find out if alternative microbicides are equally or more effective. Potential end-users in a high HIV prevalence area believe that a partially effective microbicide would be an important addition to the limited HIV prevention options for women. The significant challenges of introducing a partially protective HIV prevention option were recognised, but seen as ones worth facing, as well as an opportunity to lay the ground work for the introduction of more efficacious HIV prevention methods in the future.
authors.affiliation: The Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Mtubatuba, South Africa. mitzygafos@gmail.com
authors.forename: Mitzy
authors.initials: M
authors.lastname: Gafos
authors.forename: Misiwe A
authors.initials: MA
authors.lastname: Mzimela
authors.forename: Hlengiwe B
authors.initials: HB
authors.lastname: Ndlovu
authors.forename: Sheena
authors.initials: S
authors.lastname: McCormack
authors.forename: Nuala
authors.initials: N
authors.lastname: McGrath
mesh_terms: D000282:Administration, Intravaginal; D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008875:Middle Aged; D012424:Rural Population; D021841:Safe Sex; D013019:South Africa / Q000453:epidemiology; D014930:Women / Q000523:psychology*; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents