Abstract
The ways in which couples communicate about microbicides is likely to influence microbicide uptake and usage. We collected quantitative data about whether women in a microbicide trial discussed microbicides with their partners and explored communication about microbicides during 79 in-depth-interviews with women enrolled in the trial and 17 focus-group discussions with community members. After 4 weeks in the trial, 60 % of 1092 women had discussed microbicides with their partners; in multivariate analysis, this was associated with younger age, clinic of enrolment and not living in households that owned cattle. After 52 weeks, 84 % of women had discussed microbicides; in multivariate analysis, this was associated with not living in households that owned cattle, not living in a household that relied on the cheapest water source, allocation to 0.5 % PRO2000 gel and consistent gel adherence. Qualitative findings highlighted that women in committed relationships were expected to discuss microbicides with their partners and preferred to use microbicides with their partner’s knowledge. Women had different reasons for, and ways of, discussing microbicides and these were influenced by the couple’s decision-making roles. Although there was tolerance for the use of microbicides without a partner’s knowledge, the women who used microbicides secretly appeared to be women who were least able to discuss microbicides. In KwaZulu-Natal, socio-cultural norms informing sexual communication are amenable to microbicide introduction.
Highlights
MethodsQuantitative MethodsThe MDP 301 clinical trial has been described in detail elsewhere [39, 40]
International Standard Randomised Controlled Trial Registry (ISRCTN64716212)
After 52 weeks, 84 % of women had discussed microbicides; in multivariate analysis, this was associated with not living in households that owned cattle, not living in a household that relied on the cheapest water source, allocation to 0.5 % PRO2000 gel and consistent gel adherence
Summary
Quantitative MethodsThe MDP 301 clinical trial has been described in detail elsewhere [39, 40]. 12 women refused to participate mainly due to the time commitment, one woman withdrew from the trial before the first interview, four were never available for interview, and five were not interviewed around the time of their week 4 visit. In this analysis we included interviews with 79 trial participants who were interviewed around the time of their week 4 visit. We advertised focus group discussions (FGDs) at community events and conducted them with women and men who were resident in the trial catchment area but not enrolled in the trial. We discussed partner involvement in decisions relating to sexual matters in the community FGDs
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