title: Communicating about microbicides with women in mind: tailoring messages for specific audiences.
abstract: BACKGROUND
  Current HIV prevention options are unrealistic for most women; however, HIV prevention research has made important strides, including on-going development of antiretroviral-based vaginal microbicide gels. Nevertheless, social-behavioural research suggests that women's ability to access and use new HIV prevention technologies will be strongly influenced by a range of socio-cultural, gender and structural factors which should be addressed by communications and marketing strategies, so that these products can be positioned in ways that women can use them.
  
  
  METHODS
  Based on an extensive literature review and in-country policy consultation, consisting of approximately 43 stakeholders, we describe barriers and facilitators to HIV prevention, including potential microbicide use, for four priority audiences of Kenyan women (female sex workers [FSWs], women in stable and discordant relationships, and sexually active single young women). We then describe how messages that position microbicides might be tailored for each audience of women.
  
  
  RESULTS
  We reviewed 103 peer-reviewed articles and reports. In Kenya, structural factors and gender inequality greatly influence HIV prevention for women. HIV risk perception and the ability to consistently use condoms and other prevention products often vary by partner type. Women in stable relationships find condom use challenging because they connote a lack of trust. However, women in other contexts are often able to negotiate condom use, though they may face challenges with consistent use. These women include FSWs who regularly use condoms with their casual clients, young women in the initial stages of a sexual relationship and discordant couples. Thus, we consider two approaches to framing messages aimed at increasing general awareness of microbicides - messages that focus strictly on HIV prevention and ones that focus on other benefits of microbicides such as increased pleasure, intimacy or sexual empowerment, in addition to HIV prevention.
  
  
  CONCLUSIONS
  If carefully tailored, microbicide communication materials may facilitate product use by women who do not currently use any HIV prevention method. Conversely, message tailoring for women with high-risk perception will help ensure that microbicides are used as additional protection, together with condoms.
authors.affiliation: Social & Behavioural Health Sciences, FHI360, Durham, NC, USA; sidibes1@gmail.com.
authors.forename: Sekou
authors.initials: S
authors.lastname: Sidibe
authors.affiliation: Social & Behavioural Health Sciences, FHI360, Durham, NC, USA.
authors.forename: Allison P
authors.initials: AP
authors.lastname: Pack
authors.affiliation: Social & Behavioural Health Sciences, FHI360, Durham, NC, USA.
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Tolley
authors.affiliation: Social Marketing and Communication, FHI 360, Washington, DC, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ryan
authors.affiliation: Research, FHI 360, Nairobi, Kenya.
authors.forename: Caroline
authors.initials: C
authors.lastname: Mackenzie
authors.affiliation: Research, FHI 360, Nairobi, Kenya.
authors.forename: Emily
authors.initials: E
authors.lastname: Bockh
authors.affiliation: National AIDS and STI Control Programme, Nairobi, Kenya.
authors.forename: George
authors.initials: G
authors.lastname: Githuka
mesh_terms: D000282:Administration, Intravaginal; D000293:Adolescent; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D018890:Chemoprevention / Q000379:methods* / Q000523:psychology; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology; D058015:Health Communication; D006266:Health Education; D006801:Humans; D007630:Kenya; D008297:Male; D010342:Patient Acceptance of Health Care; D065129:Pre-Exposure Prophylaxis / Q000379:methods*; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D044966:Anti-Retroviral Agents
keywords: HIV prevention; Kenya; communication; messages; microbicide; women