Abstract:
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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. |