Attitudes of men in an Australian male tolerance study towards microbicide use

Abstract

Background Vaginal microbicides are in development to provide new options for prevention of STIs. Although promoted as a female initiated product, men may influence the decision to use a microbicide and the way that it is used, so it is important to explore their views. Methods Men (n=36) enrolled in a 7-day, phase 1 clinical safety trial of SPL7013 Gel were interviewed pre and post-use of the gel. The trial did not include use of the gel during sex. Interviews were digitally-recorded and transcribed verbatim, and analysed using a framework approach. Results The men (mean age 37 years) were interested in the idea of vaginal microbicides, had little knowledge about them, and varied beliefs about how they work. They tended to assess microbicide use in relation to condoms and lubricants. Many would want a microbicide to be as effective as condoms. Participants did not anticipate difficulties discussing use with their partners. Many thought that a microbicide would be less intrusive than condoms; some anticipated that the lubricating properties might enhance sexual pleasure. Some anticipated using a microbicide with a condom or with a lubricant, and a few raised questions about the timing of use and use during different types of sexual activity. Conclusions No major barriers to microbicide use were found in this sample of Australian men, who anticipated being willing to use them if they are shown to be safe and effective. Our findings should help to inform the design of further studies as well as future information materials and anticipatory guidance.

‘The study has taught me to be supportive of her’: empowering women and involving men in microbicide research

“…Whilst women insert the gel and are directly controlling product use, men also have opinions over whether or not the product is acceptable. Studies have been conducted in Australia to assess the issue of microbicide acceptability with a cohort of men and issues including perceptions of safety, acceptance of the gel characteristics and partner disclosure were discussed (Holmes et al 2008;Rosenthal, Holmes, and Maher 2009). The male cohort in the study were mostly positive about the use of the gel and the authors point out that enhancing men's participation in such research will assist with the ongoing development of an important HIV-prevention product.…”

“…Men have been involved in microbicide acceptability research in other contexts, including Australia where a tolerance study was carried out (Holmes, Maher, and Rosenthal 2008;Rosenthal, Holmes, and Maher 2009). A recent trial called IPREX successfully involved men who have sex with men in testing the efficacy of using emtricitabine and tenofovir as a pre-exposure prophylaxis to prevent HIV infection (Grant et al 2011).…”

Using Conjoint Analysis to Measure the Acceptability of Rectal Microbicides Among Men Who Have Sex with Men in Four South American Cities

“…Though RM are currently intended for the receptive partner during anal intercourse, we did not screen for sexual role (insertive vs. receptive) since insertive partners may be involved in the application of the product in their partners and would also have opinions related to the product's attributes. A similar approach has been used in acceptability studies of vaginal microbicides [37].…”

User-Identified Gel Characteristics: A Qualitative Exploration of Perceived Product Efficacy of Topical Vaginal Microbicides

“…Perceived product efficacy (PPE) is a key feature driving the acceptability of, and potential adherence to, HIV/STI prevention products (Bass, 2002; Greene et al, 2010; Guest et al, 2007; Holmes, Maher, & Rosenthal, 2008; Mantell, Morar, Myer, & Ramjee, 2006b; Saethre & Stadler, 2010). PPE refers to a user’s perception of the extent to which a product is capable of producing a desired result.…”

“…These properties include physicochemical and rheological aspects of gel composition and performance, such as appearance, feel, flow, coating, and dilution effects. Although prior work has suggested that users’ opinions about product efficacy may be tied to microbicides’ physical properties (Holmes et al, 2008; Saethre & Stadler, 2010; Short, Mills, Majkowski, Stanberry, & Rosenthal, 2003; Short, Succop, Ugueto, & Rosenthal, 2007), no study has yet examined the specific user sensory perceptions and experiences, elicited by specific rheological and physicochemical properties, and how they might impact perceived product efficacy or use. These are critically important questions while microbicides are still in development; it is an opportune time to change aspects of product formulation and to prepare appropriate educational strategies to support microbicide users.…”