AEGiS-14IAC: Diaphragms are well accepted in sexually active zimbabwean women.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Diaphragms are well accepted in sexually active zimbabwean women.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. TuOrD1236)

van der Straten A, Posner SF, Mapfumo O, Khumalo-Sakutukwa G, Chipato T, Callahan M, Padian N
Department of OBGYN, University of California, San Francisco, United States

BACKGROUND: In Zimbabwe where HIV prevalence is over 30%, alternative methods to condoms are urgently needed. This is an ongoing cohort study to assess acceptability and use over time of diaphragms with KY jelly among women who are inconsistent condom users.

METHODS: Women first enroll in a 2-month condom intervention phase. Inconsistent condom users are then enrolled into the diaphragm acceptability phase, receive a diaphragm educational session (including information about its unknown efficacy against HIV/STI) followed by a booster session 2 months later. Women are followed every 2 months for a total of 6 months. Demographic, behavioral and medical assessments and free condom distribution occurred at every visit.

RESULTS: 156 women have entered the diaphragm acceptability phase and follow up is ongoing. At this time, 131, 89 and 38 women have been seen at 2, 4 and 6 months, respectively. Mean age is 29 (range:17-46), 54% have completed secondary education, 97% are married and 70% have 1 lifetime partner. Prior to entering the study, only 1% had ever used diaphragms. Diaphragm uptake was almost universal following the intervention and stayed high over time. Consistent use (>1/2 time) was reported by close to half the sample. KY jelly was used almost universally with diaphragms and 69% of the sample reported using diaphragms both for disease and pregnancy prevention.

CONCLUSIONS: Virtually no studies have examined the acceptability of diaphragms in sub-Saharan Africa. When provided with appropriate counseling and education, a majority of women in our study were willing to use the diaphragm in spite of its unknown efficacy. If proven effective against HIV/STI, diaphragms used alone or in combination with microbicides may provide a viable women-controlled alternative to condoms.[table: see text]

Keywords: AEGIS, Contraceptive Devices, Female, Condoms, Coitus, Safe Sex, Prevalence, HIV Infections, Cohort Studies, HIV Seropositivity, Counseling, Zimbabwe, Africa South of the Sahara, Human, Female, Pregnancy

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TuOrD1236