High Acceptability of a Vaginal Ring Intended as a Microbicide Delivery Method for HIV Prevention in African Women

• Published in: AIDS and behavior Vol. 16; no. 7; pp. 1775 - 1786
• Main Authors: van der Straten, A., Montgomery, E. T., Cheng, H., Wegner, L., Masenga, G., von Mollendorf, C., Bekker, L., Ganesh, S., Young, K., Romano, J., Nel, A., Woodsong, C.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.10.2012; Springer Nature B.V
• Subjects: Acceptance; Administration, Intravaginal; African Continental Ancestry Group - psychology; Anti-Infective Agents - administration & dosage; Antimicrobial agents; Contraceptive Devices, Female - statistics & numerical data; Contraceptive Devices, Female - utilization; Cross-Over Studies; Data processing; Disease transmission; Elastomers; Emotions; Female; Focus Groups; Health Psychology; HIV; HIV Infections - prevention & control; Human immunodeficiency virus; Humans; Infectious Diseases; Interviews as Topic; Inventories; Medicine; Medicine & Public Health; microbicides; Multivariate Analysis; Original Paper; Patient Acceptance of Health Care - statistics & numerical data; Patient Satisfaction; Prevention; Public Health; Qualitative Research; Sex; Sexual Behavior; Sexual Partners - psychology; Sexually transmitted diseases; Silicones; Socioeconomic Factors; South Africa; STD; Surveys and Questionnaires; Tanzania; Vagina; South Africa; Tanzania; Africa; Vaginal ring; Microbicide; HIV/STI prevention; Acceptability; Africa
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-012-0215-0

Vaginal rings (VRs) are new methods for continuous delivery of microbicides. This is the first study to quantitatively and qualitatively explore the acceptability of rings in Africa: 157 HIV-negative, sexually active women aged 18–35 used a placebo silicone elastomer ring for 12 weeks. They completed product acceptability questionnaires every 4 weeks. We conducted 6 exit focus group discussions with a subset of 48 women and 19 in-depth interviews with male partners. Retention in the study was high (97 %). Initial insertion at the clinic was successful on first attempt for 81 % of participants. Most women were comfortable using the ring, and very few (≤2 %) could feel it during daily activities or had ring-related physical or emotional problems. In the qualitative interviews many participants reported that they initially had concerns about using the ring. However, only a minority of women actually reported concerns with the ring during the study. The most frequent concern was that the ring would get lost inside the body (20 %), and this was significantly correlated with study site, frequently thinking about the ring and reporting that the ring was not very easy to remove. Qualitative data suggest that informants grew to like the ring because it felt securely placed, was unnoticeable during daily activities, and felt “normal” during sex. The ring appeared to be highly acceptable for women and men. Initial concerns with this novel method suggest a need for enhanced product counseling when VRs are introduced.