A qualitative study of obstacles to diaphragm and condom use in an HIV prevention trial in sub-Saharan Africa

AIDS Education and Prevention : Official Publication of the International Society for AIDS Education
Deborah KacanekMIRA team

Abstract

Consistent condom use and the substitution of condoms with potential HIV prevention methods of lower or unknown effectiveness are important concerns in the development of new prevention technologies. This qualitative study explored obstacles to consistent condom use with the diaphragm in MIRA, an HIV prevention trial in South Africa and Zimbabwe. We conducted 26 focus group discussions (FGDs) with 206 women and 7 FGDs and 10 in-depth interviews with 41 male partners of intervention-arm women. The belief that the diaphragm/gel prevented HIV, women's difficulties negotiating condom use, and men's unawareness that using the products together was recommended were obstacles to consistent condom use with the diaphragm/gel. Concerns about protection from HIV and pregnancy, recognition that the diaphragm was not yet proven to prevent HIV or sexually transmitted infections, and the trial context were facilitators. Understanding selective study product use in HIV prevention trials may inform improved adherence counseling and male involvement strategies.

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Citations

Jan 22, 2019·The Journal of the Association of Nurses in AIDS Care : JANAC·Sylivia NalubegaCatrin Evans
Mar 9, 2017·Health Care for Women International·Sidney Ruth Schuler, Elizabeth Bukusi

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