Understanding the impact of participation in a microbicide clinical trial on condom use
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Date
2010
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Abstract
There is ongoing debate regarding the public health message of introducing a microbicide that is less efficacious than condoms into the HIV prevention field. One key issue is whether the availability of microbicides would undermine women's bargaining power to negotiate condom use. Most microbicide trials report increased condom use among participants. This analysis attempts to separate the influence of increased safer sex counselling from the direct impact of gel use as a facilitator to condom acceptability.
In-depth interviews were conducted with a random sample of women participating in the MDP 301 Phase III microbicide trial, and a sub-sample of their male partners. Data from 63 female and 5 male interviews were analysed to assess the impact that participating in a clinical trial and using a vaginal microbicide/placebo gel had on condom usage.
Two thirds of women reported not using condoms prior to study participation due to male opposition. Most of the women interviewed were unable to explain their partners' resistance to condoms. Some of the underlying factors were related to men's resistance to using condoms with a main or long term partner (as opposed to casual partners); preference for skin-to-skin contact; or rumours about negative health implications such as condoms containing maggots. A third of women started using condoms, although inconsistently, after joining the trial. Women used participation in the trial as the rationale for discussing the risks of HfV infection and condom use with their partners. Men appeared to be more willing to use condoms in the presence of gel, and this was partially due to the gel counteracting the negative effects of condom use on sexual pleasure.
Joining the trial appeared to create an opportunity for women to discuss sex with their partners, and the introduction of gel into the relationship serves as a bargaining tool for condom use with their partners.
Description
Submitted in partial fulfilment of the academic requirements for the degree:
Master of Education - Research Methodology in the Department of Educational Psychology of the Faculty of Education at the University of Zululand, 2010.
Keywords
Condom use, microbicide clinical trial