Acceptability and adherence of a candidate microbicide gel among high-risk women in Africa and India

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Date
2010Author
Greene, Elizabeth
Batona, Georges
Hallad, Jyoti
Johnson, Sethulakshmi
Neema, Stella
Tolley, Elizabeth E.
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Show full item recordAbstract
Vaginal microbicides currently under development are substances that may prevent the
transmission of HIV. Qualitative, in-depth post-trial interview data from a Phase III
clinical trial of 6% Cellulose Sulfate microbicide gel in two sites in Africa (Uganda and
Benin) and two in India (Chennai and Bagalkot) were examined in order to better
understand factors that influence microbicide acceptability and adherence in a clinical
trial setting. Women found the gel relatively easy to use with partners with whom there
were no expectations of fidelity, in situations where they had access to private space
and at times when they were expecting to engage in sexual intercourse. Adherence
to gel seemed significantly more difficult with primary partners due to decreased
perceptions of risk, inconvenience or fear of partner disapproval. Findings suggest that
women in a variety of settings may find a microbicide gel to be highly acceptable for its
lubricant qualities and protective benefits but that adherence and consistent use may
depend greatly on contextual and partner-related factors. These findings have important
implications for future trial designs, predicting determinants of microbicide use and
acceptability and marketing and educational efforts should a safe and efficacious
microbicide be found.
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