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Couples’ decision making regarding the use of multipurpose prevention technology (MPT) for pregnancy and HIV prevention

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Abstract

We conducted a secondary analysis of discrete choice experiment (DCE) data from 395 couples enrolled in the Microbicide Trials Network (MTN)-045/CUPID study in Uganda and Zimbabwe to understand couple decision making around choice of multipurpose prevention technologies (MPTs) to prevent both HIV and pregnancy. Members of couples completed the same DCE, first separately then jointly, choosing between two hypothetical MPTs in a series of nine questions. Most couples either had similar preferences at the outset or had equal decision-making around MPTs (62%). Couples with male influence (17%) were more likely to use contraceptive pills with a male partner’s knowledge and couples with female influence (21%) were less likely to have shared decision making about family planning. Males influenced discussion around MPT duration, side effects, menstrual changes, and how the vagina feels during sex. Decision making was relatively shared, though decisions around certain attributes were more likely to be dominated by male partners.

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Data Availability

Study data are available upon request from the Microbicide Trials Network by submission of a Dataset Request Form available at http://www.mtnstopshiv.org/resources. The reason for the restriction on public data deposition is because of ethical and legal restrictions.

Code Availability

Code is available through the corresponding author.

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Acknowledgements

We would like to thank the study participants and study team.

Funding

The MTN-045 study was designed and implemented by the Microbicide Trials Network (MTN). MTN was funded by the National Institute of Allergy and Infectious Diseases (UM1AI068633, UM1AI068615, UM1AI106707), with co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Mental Health, all components of the U.S. National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Authors and Affiliations

  1. RTI International, Berkeley, CA, USA

    Marie C.D. Stoner, Erica N Browne, Miriam Hartmann, Mary Kate Shapley-Quinn, Nivedita L. Bhushan & Alexandra M. Minnis

  2. Makerere University - Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda

    Juliane Etima, Doreen Kemigisha & Clemensia Nakabiito

  3. Clinical Trials Research Centre, University of Zimbabwe, Harare, Zimbabwe

    Petina Musara, Prisca Mutero & Nyaradzo M. Mgodi

  4. National Institute of Allergy and Infectious Diseases, National Institutes of Health, Maryland, USA

    Jeanna Piper

  5. ASTRA Consulting, Kensington, CA,, USA

    Ariane van der Straten

  6. Department of Medicine, University of California, San Francisco, USA

    Ariane van der Straten

Authors
  1. Marie C.D. Stoner
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  2. Erica N Browne
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  3. Juliane Etima
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  4. Petina Musara
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  5. Miriam Hartmann
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  6. Mary Kate Shapley-Quinn
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  7. Doreen Kemigisha
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  8. Prisca Mutero
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  9. Nyaradzo M. Mgodi
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  10. Clemensia Nakabiito
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  11. Nivedita L. Bhushan
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  12. Jeanna Piper
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  13. Ariane van der Straten
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  14. Alexandra M. Minnis
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Contributions

AM and JE led study development and oversight as protocol chair and co-chair. JE, PM, DK, NMM and CN led data collection activities at their research sites and contributed to interpretation of results. PM, NMM and CN provided leadership as site investigators. MKSQ provided overall study coordination and contributed to study development and interpretation of results. MH was involved in study development, particularly couples’ elements such as their recruitment and the observation tool. MCDS led manuscript writing and development and conducted analysis. EB conducted data management and analysis, synthesized results and contributed to drafting the manuscript. NM provided operational leadership as clinical research manager. JP contributed as DAIDS medical officer with key contributions to protocol development and management. AVDS contributed to study development and results interpretation as the protocol’s MTN Behavioral Research Working Group representative. NB contributed to interpretation of data and review of results and the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Marie C.D. Stoner.

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Conflict of interest

The authors have no conflicts of interest or financial interests relevant to this article to disclose.

Ethics approvals

All study procedures were approved by the following ethics committees or institutional review boards: the Medical Research Council of Zimbabwe; the Joint Research Ethics Committee for the University of Zimbabwe, the Research Council of Zimbabwe Chitungwiza City Health Department; the Joint Clinical Research Centre Research Ethics Committee in Uganda; the Uganda National Council for Science and Technology; Johns Hopkins School of Medicine Institutional Review Board in the United States; and the Advarra Institutional Review Board in the United States.

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All participants provided written informed consent.

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Stoner, M.C., Browne, E.N., Etima, J. et al. Couples’ decision making regarding the use of multipurpose prevention technology (MPT) for pregnancy and HIV prevention. AIDS Behav 27, 198–207 (2023). https://doi.org/10.1007/s10461-022-03756-9

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  • DOI: https://doi.org/10.1007/s10461-022-03756-9

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