title: Characteristics of women screened for a contraceptive intravaginal ring study in Kisumu, Kenya, 2014.
abstract: BACKGROUND
  HIV antiretroviral-based intravaginal rings with and without co-formulated contraception hold promise for increasing HIV prevention options for women. Acceptance of and ability to correctly and consistently use this technology may create challenges for future ring-based microbicide trials in settings where this technology has not been introduced. We examined baseline factors associated with enrolling in a contraceptive intravaginal ring study in Kisumu, Kenya and describe notional acceptability (willingness to switch to a contraceptive ring based solely on information received about it).
  
  
  METHODS
  Demographic, psychosocial, and behavioral eligibility screening of women 18-34 years was undertaken. Testing for pregnancy, HIV, and other sexually transmitted infections (STIs) was also conducted. We compared enrollment status across groups of categorical predictors using prevalence ratios (PR) and 95% confidence interval (CI) estimates obtained from a log-binomial regression model.
  
  
  RESULTS
  Out of 692 women pre-screened April to November 2014, 463 completed screening, and 302 women were enrolled. Approximately 97% of pre-screened women were willing to switch from their current contraceptive method to use the intravaginal ring exclusively for the 6-month intervention period. Pregnancy, HIV, and STI prevalence were 1.7%, 14.5%, and 70.4% respectively for the 463 women screened. Women 18-24 (PR=1.47, CI 1.15-1.88) were more likely to be enrolled than those 30-34 years of age, as were married/cohabitating women (PR=1.62, CI 1.22-2.16) compared to those separated, divorced, or widowed. In adjusted analyses, sexual debut at less than 17 years of age, one lifetime sexual partner, abnormal vaginal bleeding in the past 12 months, condomless vaginal or anal sex in the past 3 months, and not having a sexual partner of unknown HIV status in the past 3 months were predictive of enrollment.
  
  
  CONCLUSIONS
  High notional acceptability suggests feasibility for contraceptive intravaginal ring use. Factors associated with ring use initiation and 6-month use will need to be assessed.
authors.affiliation: Centers for Disease Control and Prevention, Office of Infectious Diseases, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia.
authors.forename: Eleanor
authors.initials: E
authors.lastname: McLellan-Lemal
authors.affiliation: Centers for Disease Control and Prevention, Office of Infectious Diseases, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Gust
authors.affiliation: Centers for Disease Control and Prevention, Office of Infectious Diseases, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia.
authors.forename: Roman
authors.initials: R
authors.lastname: Gvetadze
authors.affiliation: Centers for Disease Control and Prevention, Office of Infectious Diseases, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia; Engility Corporation, Atlanta, GA, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Furtado
authors.affiliation: Nyanza Reproductive Health Society, Kisumu, Kenya.
authors.forename: Fredrick O
authors.initials: FO
authors.lastname: Otieno
authors.affiliation: Centers for Disease Control and Prevention, Office of Infectious Diseases, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia.
authors.forename: Mitesh
authors.initials: M
authors.lastname: Desai
authors.affiliation: Centers for Disease Control and Prevention, Office of Infectious Diseases, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Kisumu, Kenya.
authors.forename: Clement
authors.initials: C
authors.lastname: Zeh
authors.affiliation: Centers for Disease Control and Prevention, Office of Infectious Diseases, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia.
authors.forename: Taraz
authors.initials: T
authors.lastname: Samandari
authors.affiliation: Kenya Medical Research Institute, Kisumu, Kenya.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Nyagol
authors.affiliation: Kenya Medical Research Institute, Kisumu, Kenya.
authors.forename: Esther M
authors.initials: EM
authors.lastname: Makanga
keywords: HIV and STI prevalence; Kenya; Women; biomedical technology; contraceptive intravaginal ring; pregnancy; reproductive health; sexual behavior