Barrier Method Preferences and Perceptions Among Zimbabwean Women and their Partners
In Zimbabwe, adult HIV prevalence is over 25% and acceptable prevention methods are urgently needed. Sixty-eight Zimbabwean women who had completed a barrier-methods study and 34 of their male partners participated in focus group discussions and in-depth interviews to qualitatively explore acceptability of male condoms, female condoms and diaphragms. Most men and about half of women preferred diaphragms because they are female-controlled and do not detract from sexual pleasure or carry stigma. Unknown efficacy and reuse were concerns and some women reported feeling unclean when leaving the diaphragm in for six hours following sex. Nearly half of women and some men preferred male condoms because they are effective and limit women's exposure to semen, although they reportedly detract from sexual pleasure and carry social stigma. Female condoms were least preferred because of obviousness and partial coverage of outer-genitalia that interfered with sexual pleasure.
KEY WORDS:acceptability barrier methods HIV prevention contraception female-controlled methods condoms diaphragm
This study was supported by the Centers for Disease Control and Prevention (CDC) and Contraceptive Research and Development (CONRAD) Program. We would like to gratefully acknowledge the participants without whom this study would not have been possible.
- AIDS Epidemic Update 2003. (2003). Geneva: © Joint United Nations Programme on HIV/AIDS (UNAIDS) and World Health Organization (WHO) 2003.Google Scholar
- Ellertson, C., and Burns, M. (2003). Re-examining the Role of Cervical Barrier Devices. OUTLOOK, 20(2), 1–8.Google Scholar
- Fontanet, A. L., Saba, J., Chandelying, V., Sakondhavat, C., Bhiraleus, P., Rugpao, S., et al. (1998). Protection against sexually transmitted diseases by granting sex workers in Thailand the choice of using the male or female condom: results from a randomized controlled trial. Aids, 12(14), 1851–1859.PubMedCrossRefGoogle Scholar
- Heise, L. L. (1997). Beyond acceptability : reorienting research on contraceptive choice. In Beyond acceptability: users' perspectives on contraception, [compiled by] World Health Organization [WHO], Reproductive Health Matters (pp. 6–14): London, England, Reproductive Health Matters.Google Scholar
- Malcolm, K., Lowry, D., and Woolfson, D. (2004, March 28–31). In vitro release of dextran sulfate from silicone intravaginal rings. Paper presented at the Microbicides 2004, London, UK.Google Scholar
- Posner, S., van der Straten, A., Kang, M., Chipato, T., and Padian, N. (2004, March 28–31). The effect of introducing the diaphragm on male condom use. Paper presented at the Microbicides 2004, London, UK.Google Scholar
- Ravindran, T. S., and Sumathy, A. R. (1997). Is the diaphragm a suitable method of contraception for low-income women: A user-perspective study, Madras, India. Beyond Acceptability: User's perspectives on contraception—Out of print—A World Health Organization Monograph.Google Scholar
- Snow, R., Garcia, S., Kureshy, N., Sadana, R., Singh, S., Becerra-Valdivia, M., et al. (1997). Attributes of contraceptive technology : women's preferences in seven countries. In Beyond acceptability: users' perspectives on contraception, [compiled by] World Health Organization [WHO], Reproductive Health Matters (pp. 36–48): London, England, Reproductive Health Matters.Google Scholar
- van der Straten, A., Montgomery, L., Kamba, M., Kang, M., Posner, S., Chipato, T., et al. (2004, March 28–31). Preference for gel use with diaphragms in Zimbabwe. Paper presented at the Microbicides 2004, London, UK.Google Scholar
- Weller, S., and Davis, K. (2002). Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database Syst Rev, 3, CD003255.Google Scholar