AEGiS-15IAC: Partner involvement in female-controlled method use: Experience with the diaphragm in Zimbabwe.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Partner involvement in female-controlled method use: Experience with the diaphragm in Zimbabwe.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. ThOrC1376)

van der Straten A, Kang MS, Buck J, Khumalo-Sakutukwa G, Chipato T, Posner SF, Padian N
Department of OBGYN, University of California San Francisco, San Francisco, United States

BACKGROUND: The diaphragm is being evaluated as a barrier method against HIV/STIs. Although it is "female-controlled", partner acceptance and involvement may nevertheless be necessary for some women. We assessed quantitatively and qualitatively male partner involvement among women in a diaphragm acceptability study in Zimbabwe.

METHODS: A total of 181 women recruited from family planning clinics completed a six-month prospective study. At entry, they were fitted with a diaphragm, received an educational intervention, and were told to use diaphragm with male condoms for every sex act. At their last follow-up visit, women completed a behavioral survey. Additionally, after study completion, 7 Focus Group Discussions (FGD) and 13 in-depth interviews (IDI) were conducted with 69 female participants and 7 FGD were conducted with 36 of their partners.

RESULTS: Of the 181 women, median age was 26.5 (range 16-45), 97% were married with 6 years median relationship length (0.17-25). At last visit, 96% women had used the diaphragm and of those, 82% reported complete control over its use, 86% had told their partner when they used the diaphragm, and of those, 94% said their partner thought it was "a very good idea", 45% said he preferred diaphragm over condoms, 32% said it was "very important" to him that he could not tell when she used the diaphragm. FGD and IDI confirmed a wide range of partner involvement: from none at all (complete clandestine use) to active participation in inserting/removing the diaphragm. Many women preferred to seek partner permission and, men thought that their general permission was required. However, they did not care about each instance the diaphragm was used. Indeed, they liked that it was unnoticeable and did not require compliance on their part.

CONCLUSIONS: Although diaphragms can be used clandestinely, passive acquiescence by the partner is preferable in many relationships.

Keywords: AEGIS, Contraceptive Devices, Female, Condoms, Family Planning Services, Patient Compliance, Contraception, Barrier, Interviews, Zimbabwe, Prospective Studies, Female, Humans, Male, utilization, methods

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ThOrC1376