Communication About Microbicide Use Between Couples in KwaZulu-Natal, South Africa

The ways in which couples communicate about microbicides is likely to influence microbicide uptake and usage. We collected quantitative data about whether women in a microbicide trial discussed microbicides with their partners and explored communication about microbicides during 79 in-depth-interviews with women enrolled in the trial and 17 focus-group discussions with community members. After 4 weeks in the trial, 60 % of 1092 women had discussed microbicides with their partners; in multivariate analysis, this was associated with younger age, clinic of enrolment and not living in households that owned cattle. After 52 weeks, 84 % of women had discussed microbicides; in multivariate analysis, this was associated with not living in households that owned cattle, not living in a household that relied on the cheapest water source, allocation to 0.5 % PRO2000 gel and consistent gel adherence. Qualitative findings highlighted that women in committed relationships were expected to discuss microbicides with their partners and preferred to use microbicides with their partner's knowledge. Women had different reasons for, and ways of, discussing microbicides and these were influenced by the couple's decision-making roles. Although there was tolerance for the use of microbicides without a partner's knowledge, the women who used microbicides secretly appeared to be women who were least able to discuss microbicides. In KwaZulu-Natal, socio-cultural norms informing sexual communication are amenable to microbicide introduction

Communication about microbicide use between couples

Abstract The ways in which couples communicate about microbicides is likely to influence microbicide uptake and usage. We collected quantitative data about whether women in a microbicide trial discussed microbicides with their partners and explored communication about microbicides during 79 in-depth-interviews with women enrolled in the trial and 17 focus-group discussions with community members. After 4 weeks in the trial, 60 % of 1092 women had discussed microbicides with their partners; in multivariate analysis, this was associated with younger age, clinic of enrolment and not living in households that owned cattle. After 52 weeks, 84 % of women had discussed microbicides; in multivariate analysis, this was associated with not living in households that owned cattle, not living in a household that relied on the cheapest water source, allocation to 0.5 % PRO2000 gel and consistent gel adherence. Qualitative findings highlighted that women in committed relationships were expected to discuss microbicides with their partners and preferred to use microbicides with their partner's knowledge. Women had different reasons for, and ways of, discussing microbicides and these were influenced by the couple's decision-making roles. Although there was tolerance for the use of microbicides without a partner's knowledge, the women who used microbicides secretly appeared to be women who were least able to discuss microbicides. In KwaZulu-Natal, socio-cultural norms informing sexual communication are amenable to microbicide introduction

The implications of post-coital intravaginal cleansing for the introduction of vaginal microbicides in South Africa.

Post-coital intravaginal cleansing (IVC) could counteract the protective effect of a vaginal microbicide. IVC less than 1 h after sex is discouraged in most microbicide trials. During a microbicide trial in KwaZulu-Natal, we collected quantitative data on post-coital IVC. We discussed IVC during in-depth-interviews (IDIs) and focus-group discussions (FGDs) with women enrolled in the trial, and during FGDs with community members. Nearly one-third (336/1,143) of women reported IVC less than an hour after sex. In multivariate analysis, post-coital IVC was associated with younger age, larger household size, greater sexual activity, consistent gel use, and clinic of enrolment. During IDIs and FGDs, respondents described post-coital IVC as a common hygiene practice motivated by the need to remove semen, vaginal fluids and sweat, although this practice may be amenable to change in the context of microbicide use. We need to consider strategies for influencing post-coital IVC practices in future microbicide trials and delivery programmes

Measuring and assessing variability of data on self-reported sexual behaviour collected using different methods

Assignment (MPhil)--University of Stellenbosch, 2007.ENGLISH ABSTRACT: This study investigated the variability in self-reported sexual behavior data collected using different methods. The motivation for the study was to better understand sexual behaviour as a means of reducing HIV incidence among women. Respondents for the study were women enrolled in the Microbicides Development Programme pilot study at the Africa Centre for Health and Population Studies in the Umkhanyakude district of KwaZulu Natal, South Africa. These 51 women were asked to use a placebo vaginal gel before sex for 4 weeks. Three methods of sexual behaviour data collection were used in order to evaluate the accuracy of data collected. A coital diary was kept for all 4 weeks, a sexual behaviour questionnaire was administered at the end of 4 weeks and then an in-depth interview was conducted within the following week. Variations in reporting were subsequently probed regarding reporting of the number of sex acts, condom usage, and gel usage. There was a variance in individual reports – using different data collection tools – of numbers of sexual acts, condom use, and gel use. The majority of discrepancies were reported by the women to be due to misunderstandings or recall bias. The study concludes that using multiple methods of sexual behaviour data collection methods adds value in terms of being able to report on the level of variance thereby improving the confidence with which the data can be interpreted. Further analysis of the in-depth interviews is necessary to assess the level of social desirability bias. Variability does exist among data collection methods, but case record forms could be used as a substitute for in depth interviews in large scale microbicides clinical trials since this variability is not major.AFRIKAANSE OPSOMMING: Hierdie studie het die afwyking in self-aangemelde seksuele gedrag deur verskillende metodes bestudeer. Die motivering vir die studie was om seksuele gedrag beter te verstaan en die kennis aan te wend as ‘n metode om MIV infeksie by vroue te verminder. Respondente vir die studie was ingeskrewe vroue in die ‘Microbicides Development Programme’ loods navorsingsprojek by die ‘Africa Centre for Health and Population Studies’ in die Umkhanyakude distrik van KwaZulu-Natal, Suid-Afrika. Hierdie 51 vroue is gevra om vir 4 weke ʼn placebo jel te gebruik voordat hulle seksueel verkeer. Drie metodes is gebruik om data te versamel oor seksuele gedrag om die akkuraatheid van die data te evalueer. Respondente is gevra om dagboek van hul seksuele aktiwiteite vir die 4 weke te hou, om ʼn seksuele gedrag vraelys aan die einde van die 4 weke voltooi, en 'n diepte onderhoud binne die volgende week te voer. Afwykings in verslaggewing is verder bespreek met betrekking tot die aantal seksuele dade, gebruik van kondome en gebruik van jel. Daar was afwyking in individuele rapportering – deur verskeie data insamelings gereedskap te gebruik – van aantal seksuele dade, kondoom gebruik, en die gebruik van jel. Die meerderheid van hierdie afwykings wat gerapporteer is, was as gevolg van misverstande en onewewigtige herroepping. Die gevolgtrekking van hierdie studie is dat die gebruik van veelvuldige metodes om inligting oor seksuele gedrag te versamel die waarde verhoog in terme van die vermoë om te rapporteer oor die vlak van afwyking en daardeur verhoog dit die akkuraatheid waarmee die inligting verklaar kan word. Verdere analise van die in-diepte onderhoude is nodig om die vlak van sosiale aanvaarbaarheid te bepaal. Daar bestaan veranderlikheid tussen die verskillende data insamelingsmetodes, maar ‘n siekteverslag kan in-diepte onderhoude in grootskaalse kliniese eksperimente vervang, aangesien die veranderlikheid nie groot is nie

Communication About Microbicide Use Between Couples in KwaZulu-Natal, South Africa

The ways in which couples communicate about microbicides is likely to influence microbicide uptake and usage. We collected quantitative data about whether women in a microbicide trial discussed microbicides with their partners and explored communication about microbicides during 79 in-depth-interviews with women enrolled in the trial and 17 focus-group discussions with community members. After 4 weeks in the trial, 60 % of 1092 women had discussed microbicides with their partners; in multivariate analysis, this was associated with younger age, clinic of enrolment and not living in households that owned cattle. After 52 weeks, 84 % of women had discussed microbicides; in multivariate analysis, this was associated with not living in households that owned cattle, not living in a household that relied on the cheapest water source, allocation to 0.5 % PRO2000 gel and consistent gel adherence. Qualitative findings highlighted that women in committed relationships were expected to discuss microbicides with their partners and preferred to use microbicides with their partner's knowledge. Women had different reasons for, and ways of, discussing microbicides and these were influenced by the couple's decision-making roles. Although there was tolerance for the use of microbicides without a partner's knowledge, the women who used microbicides secretly appeared to be women who were least able to discuss microbicides. In KwaZulu-Natal, socio-cultural norms informing sexual communication are amenable to microbicide introduction