Abstract
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.
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.
- Content Type Journal Article
- Category Original Paper
- Pages 1-12
- DOI 10.1007/s10461-012-0215-0
- Authors
- A. van der Straten, Women’s Global Health Imperative, RTI International, 114 Sansome Street, Suite 500, San Francisco, CA 94104, USA
- E. T. Montgomery, Women’s Global Health Imperative, RTI International, 114 Sansome Street, Suite 500, San Francisco, CA 94104, USA
- H. Cheng, Women’s Global Health Imperative, RTI International, 114 Sansome Street, Suite 500, San Francisco, CA 94104, USA
- L. Wegner, Women’s Global Health Imperative, RTI International, 114 Sansome Street, Suite 500, San Francisco, CA 94104, USA
- G. Masenga, Kiliminjaro Christian Medical Center, Moshi, Tanzania
- C. von Mollendorf, Wits Reproductive Health and HIV Research Institute, Johannesburg, South Africa
- L. Bekker, University of Cape Town and Desmond Tutu HIV Foundation, Cape Town, South Africa
- S. Ganesh, South African Medical Research Council, Durban, South Africa
- K. Young, International Partnership for Microbicides, Paarl, South Africa
- J. Romano, NWJ Group, LLC, Wayne, PA, USA
- A. Nel, International Partnership for Microbicides, Paarl, South Africa
- C. Woodsong, International Partnership for Microbicides, Paarl, South Africa
- Journal AIDS and Behavior
- Online ISSN 1573-3254
- Print ISSN 1090-7165