Zoë Baker1, Marjan Javanbakht2, Janell Moore2, Hannah Brosnan2, Kathleen Squires3,4, Katherine Bunge5, Gregory Zimet6, Barbara Mensch7, Lydia Soto-Torres8, Bill Kapogiannis9, Lisa Levy10, Craig Hoesley11, Daniel Reirden12, Aditya Gaur13, Kenneth Mayer14, Donna Futterman15, Pamina Gorbach2. 1. Division of Urology, Children's Hospital Los Angeles, Los Angeles, CA. 2. Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA. 3. Division of Infectious Diseases, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA. 4. Global Center of Scientific Affairs, Merck Research Labs, Rahway, NJ. 5. Department of Obstetrics, Gynecology & Reproductive Services, University of Pittsburgh, Pittsburgh, PA. 6. Department of Pediatrics, Indiana University, Bloomington, IA. 7. Population Council, New York, NY. 8. National Institute of Allergy and Infectious Diseases, Division of AIDS, Bethesda, MD. 9. Maternal and Pediatric Infectious Disease Branch, National Institute of Child Health and Human Development, Bethesda, MD. 10. FHI 360, Durham, NC. 11. Division of Infectious Diseases, University of Alabama, Birmingham, AL. 12. Department of Adolescent Medicine, Children's Hospital Colorado, Aurora, CO. 13. Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN. 14. Department of Global Health and Population, Harvard School of Public Health, The Fenway Institute, Boston, MA; and. 15. Department of Pediatrics, Albert Einstein College of Medicine, the Bronx, NY.
Abstract
OBJECTIVE: This study aims to assess the product-related, relationship-related, and sex-related factors that act as facilitators and barriers to the acceptability of a vaginal ring (VR) for HIV prevention among adolescent girls. DESIGN: Qualitative study. METHODS: Ninety-six girls aged 15-17 years from 6 urban US sites were enrolled in MTN-023/IPM 030, a 24-week randomized controlled trial, for assessing the safety and acceptability of a dapivirine VR for HIV prevention. At week 24, 21 girls were randomly selected to participate in in-depth interviews. Interviews were transcribed verbatim and data analyzed using a thematic analysis approach. Facilitators and barriers to VR acceptability related to participants' relationships, sexual activity, and characteristics of the VR product were identified. RESULTS: Factors related to relationships rarely seemed to act as barriers to VR acceptability; most participants disclosed VR use to sexual partners, and positive reactions from sexual partners, which were common, seemed to facilitate VR acceptability. Emotional and/or physical discomfort surrounding VR use during sex was mentioned occasionally as a barrier to VR acceptability. Product characteristics were most frequently mentioned as barriers to VR acceptability. Many participants reported concerns about the large size of the VR on first impression. Although most found the VR comfortable, some reported pain with VR insertion. Several participants were concerned about VR cleanliness, particularly during menstruation. CONCLUSION: Product considerations, specifically size and use during menstruation, were the most commonly reported barriers to VR acceptability in this study. Adolescent girls may require additional counseling to assuage product concerns regarding a VR for HIV prevention.
OBJECTIVE: This study aims to assess the product-related, relationship-related, and sex-related factors that act as facilitators and barriers to the acceptability of a vaginal ring (VR) for HIV prevention among adolescent girls. DESIGN: Qualitative study. METHODS: Ninety-six girls aged 15-17 years from 6 urban US sites were enrolled in MTN-023/IPM 030, a 24-week randomized controlled trial, for assessing the safety and acceptability of a dapivirine VR for HIV prevention. At week 24, 21 girls were randomly selected to participate in in-depth interviews. Interviews were transcribed verbatim and data analyzed using a thematic analysis approach. Facilitators and barriers to VR acceptability related to participants' relationships, sexual activity, and characteristics of the VR product were identified. RESULTS: Factors related to relationships rarely seemed to act as barriers to VR acceptability; most participants disclosed VR use to sexual partners, and positive reactions from sexual partners, which were common, seemed to facilitate VR acceptability. Emotional and/or physical discomfort surrounding VR use during sex was mentioned occasionally as a barrier to VR acceptability. Product characteristics were most frequently mentioned as barriers to VR acceptability. Many participants reported concerns about the large size of the VR on first impression. Although most found the VR comfortable, some reported pain with VR insertion. Several participants were concerned about VR cleanliness, particularly during menstruation. CONCLUSION: Product considerations, specifically size and use during menstruation, were the most commonly reported barriers to VR acceptability in this study. Adolescent girls may require additional counseling to assuage product concerns regarding a VR for HIV prevention.
Authors: Barbara S Mensch; Barbra A Richardson; Marla Husnik; Elizabeth R Brown; Flavia Matovu Kiweewa; Ashley J Mayo; Jared M Baeten; Thesla Palanee-Phillips; Ariane van der Straten Journal: AIDS Behav Date: 2019-02
Authors: Jeanne M Marrazzo; Gita Ramjee; Barbra A Richardson; Kailazarid Gomez; Nyaradzo Mgodi; Gonasagrie Nair; Thesla Palanee; Clemensia Nakabiito; Ariane van der Straten; Lisa Noguchi; Craig W Hendrix; James Y Dai; Shayhana Ganesh; Baningi Mkhize; Marthinette Taljaard; Urvi M Parikh; Jeanna Piper; Benoît Mâsse; Cynthia Grossman; James Rooney; Jill L Schwartz; Heather Watts; Mark A Marzinke; Sharon L Hillier; Ian M McGowan; Z Mike Chirenje Journal: N Engl J Med Date: 2015-02-05 Impact factor: 91.245
Authors: Kelsey K Case; Peter D Ghys; Eleanor Gouws; Jeffrey W Eaton; Annick Borquez; John Stover; Paloma Cuchi; Laith J Abu-Raddad; Geoffrey P Garnett; Timothy B Hallett Journal: Bull World Health Organ Date: 2012-09-14 Impact factor: 9.408
Authors: Kate Shannon; Karen Leiter; Nthabiseng Phaladze; Zakhe Hlanze; Alexander C Tsai; Michele Heisler; Vincent Iacopino; Sheri D Weiser Journal: PLoS One Date: 2012-01-11 Impact factor: 3.240