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Preferences and Acceptability of Vaginal Delivery Forms for HIV Prevention Among Women, Male Partners and Key Informants in South Africa and Zimbabwe: Qualitative Findings


The attributes of an HIV microbicide may affect its acceptability, uptake and use. Quatro, a clinical study with a qualitative component, was conducted to elicit input from end-users and key informants (KIs) on four different placebo vaginal microbicide delivery forms; fast dissolving insert, ring, film and gel. In-depth interviews and focus group discussions were conducted with young women, their male partners and KIs, to explore acceptability and preferences of the four placebo products, with the intention of improving product attributes, adherence, and consequently, long term effectiveness. None of the four microbicide delivery forms stood well above others as the most preferred. Product attributes; long-action, ease of use, invisibility, female initiated and non-interference during sex were favourable in both countries. Despite preference for the long-action, on-demand products were the most liked by women. Qualitative data from the Quatro study provided rich feedback on specific attributes important to the acceptability of four HIV prevention product platforms currently in development, enabling more informed and guided product development efforts moving forward.

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We would like to thank the participants of this study for their dedication and the full study team for their contribution to the implementation and analysis of this study. The Quatro study products were provided by CONRAD (led by Tim McCormick), and in partnership with Lisa Rohan at University of Pittsburgh for film supplies. The Quatro study was funded by the United States Agency for International Development (USAID) through a sub-agreement (MAPS2-15-053) under a Cooperative Agreement (AID-OAA-A-14-00010) to CONRAD, Eastern Virginia Medical School (EVMS), and by the Bill & Melinda Gates Foundation through a sub-agreement (GSB-S-15-001)and a Grant to CONRAD/EVMS (OPP1114939). The views expressed by the author(s) do not necessarily reflect the views of USAID, the United States Government, or the Bill & Melinda Gates Foundation.

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Correspondence to Petina Musara.

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Ethical Approval

All procedures were reviewed and approved by ethics and regulatory bodies in the US (Chesapeake IRB: 00150063), South Africa (Human Research Ethics Committee of the University of the Witwatersrand (151106); Medicines Control Council (DB: N2/19/8/2)) and Zimbabwe (Medical Research Council of Zimbabwe (MRCZ/A/1988), Medicines Control Authority of Zimbabwe (B/279/5/07/2016)) before implementation.

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Written informed consent was obtained from all the participants enrolled in the study.

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Musara, P., Milford, C., Shapley-Quinn, M.K. et al. Preferences and Acceptability of Vaginal Delivery Forms for HIV Prevention Among Women, Male Partners and Key Informants in South Africa and Zimbabwe: Qualitative Findings. AIDS Behav 25, 124–138 (2021).

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  • Vaginal microbicide delivery forms
  • Facilitators
  • Barriers
  • HIV prevention
  • sub-Saharan Africa