“Set it and Forget it”: Women’s Perceptions and Opinions of Long-Acting Topical Vaginal Gels

Berg, Jacob J. van den; Rosen, Rochelle K.; Bregman, Dana; Thompson, Lara; Jensen, Kathleen M.; Kiser, Patrick F.; Katz, David F.; Buckheit, Karen W.; Buckheit, Robert W.; Morrow, Kathleen M.

doi:10.1007/s10461-013-0652-4

Cited by 30 publications

(24 citation statements)

References 25 publications

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“…Women appreciated the monthly regimen and the ring's discretion – no one else knew it was being used. Overall participants endorsed the viewpoint that one could ‘set and forget’ [19] the ring (Table 2, B, D). …”

Section: Resultsmentioning

confidence: 93%

Acceptability and use of a dapivirine vaginal ring in a phase III trial

Montgomery¹,

Straten

Chitukuta

et al. 2017

Aids

106

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Background The MTN-020/ASPIRE trial evaluated the safety and effectiveness of the dapivirine vaginal ring for prevention of HIV-1 infection among African women. A nested qualitative component was conducted at six of 15 study sites in Uganda, Malawi, Zimbabwe and South Africa to evaluate acceptability of and adherence to the ring. Method Qualitative study participants (n = 214) were interviewed with one of three modalities: single in-depth interview, up to three serial interviews or an exit Focus Group Discussion. Using semistructured guides administered in local languages, 280 interviews were audio-recorded, transcribed, translated, coded and analyzed. Results We identified three key findings: first, despite initial fears about the ring's appearance and potential side effects, participants grew to like it and developed a sense of ownership of the ring once they had used it. Second, uptake and sustained adherence challenges were generally overcome with staff and peer support. Participants developed gradual familiarity with ring use through trial progression, and most reported that it was easy to use and integrate into their lives. Using the ring in ASPIRE was akin to joining a team and contributing to a broader, communal good. Third, the actual or perceived dynamics of participants' male partner relationship(s) were the most consistently described influence (which ranged from positive to negative) on participants' acceptability and use of the ring. Conclusion It is critical that demonstration projects address challenges during the early adoption stages of ring diffusion to help achieve its potential public health impact as an effective, long-acting, female-initiated HIV prevention option addressing women's disproportionate HIV burden.

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Section: Resultsmentioning

confidence: 93%

Acceptability and use of a dapivirine vaginal ring in a phase III trial

Montgomery¹,

Straten

Chitukuta

et al. 2017

Aids

106

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“…The attribute that participants liked most about the ring was being able to forget about it. Being worry free and able to “forget it” were salient characteristics of other topical dosage forms as well (21). The least liked attributes were related to the size and thickness of the ring, which resulted in minor insertion problems for some participants.…”

Section: Discussionmentioning

confidence: 99%

Adherence and Acceptability of a Multidrug Vaginal Ring for HIV Prevention in a Phase I Study in the United States

et al. 2016

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We evaluated the adherence and acceptability of a vaginal ring containing dapivirine, maraviroc, or both drugs for 28 days during a Phase I placebo-controlled trial in 48 HIV-negative sexually abstinent U.S. women aged 18 to 40. Adherence was assessed weekly by clinical interview and computer-assisted self-interviewing; acceptability assessment occurred at the last product-use visit. Study retention was 98% (47/48); 94% (45/48) reported being fully adherent with ring use during the 28-day period. Two participants experienced the ring partially coming out. Analysis was blinded and behavioral data were combined across study groups. Most women reported being very comfortable having the ring in their vagina; 44% preferred continuous use, whereas 51% had no preference compared to episodic use. Although a range of minor ring concerns were expressed, few were actually experienced. High adherence to and acceptability of this vaginal ring in this Phase I trial contributes to its promise as a sustained mechanism for multidrug vaginal microbicide delivery.

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“…Women in a recent study in the United States also shared the perception that any foreign substance, such as a vaginal gel, would be invasive (van den Berg et al, 2014). One contradiction emerging from our findings relates to women’s reported reluctance to insert study gels into their vaginas, however at the same time a high reported prevalence of vaginal practices involving the insertion of ‘culturally approved’ products into the vagina.…”

Section: Discussionmentioning

confidence: 99%

Achieving the Optimal Vaginal State: Using Vaginal Products and Study Gels in Uganda, Zimbabwe, and South Africa

Duby

Mensch

Hartmann

et al. 2017

International Journal of Sexual Health

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Preferences and practices related to the vaginal condition have implications for the use of vaginal HIV prevention products. We used qualitative methods to explore narratives relating to the vaginal state amongst women in South Africa, Uganda and Zimbabwe who had previously participated in a biomedical HIV prevention trial. We investigated women’s behaviours related to optimising the vaginal state, experiences and perceptions of the gel’s effect on the vaginal state and on penile-vaginal intercourse, women’s narratives on male partner perceptions, and how preferences relating to the vaginal state may have interfered with gel use.

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“Set it and Forget it”: Women’s Perceptions and Opinions of Long-Acting Topical Vaginal Gels

Cited by 30 publications

References 25 publications

Acceptability and use of a dapivirine vaginal ring in a phase III trial

Acceptability and use of a dapivirine vaginal ring in a phase III trial

Adherence and Acceptability of a Multidrug Vaginal Ring for HIV Prevention in a Phase I Study in the United States

Achieving the Optimal Vaginal State: Using Vaginal Products and Study Gels in Uganda, Zimbabwe, and South Africa

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