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National HIV Prevention Conference
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[TITLE:] ACCEPTABILITY AND LONG-TERM USE OF MICROBICIDES AND OTHER FEMALE BARRIER METHODS FOR HIV/STI PREVENTION: CONTEXT MAKES A DIFFERENCE
Natl HIV Prev Conf. 2005 Jun 12-15 (abstract no. MR-A0101)
Mantell, JE; Exner, T; Hoffman, S; Dworkin, S; Stein, Z
HIV Center for Clinical & Behavioral Studies, NYS Psychiatric Institute and Columbia University, New York, NY
ISSUE: Women's steadily increasing vulnerability to HIV/AIDS and the lack of methods that enable women to protect themselves have priorirized the global health need for methods that women can initiate. These include physical and chemical barriers such as the female condom, diaphragm, cervical cap, and potential microbicides. Yet, little is known about the complex interplay of contextual factors likely to influence method acceptability and sustained use and how they may reduce rather than reproduce the inherent limitations of male condom use.
KEY POINTS: Cross-cutting contextual issues affecting method acceptability and long-term use include diversities in gender relations, economic dependence, communication and trust between partners, fertility desires, the effects on sexual pleasure, cultural practices related to sex and the body, and situational aspects of the sexual encounter. In addition,with the likelihood that microbicides and other new methods may have lower efficacy than female/male condoms, principles of harm-reduction and the benefits of partially effective methods need to be factored into how providers introduce and promote these methods.
IMPLICATIONS: Interventions need to address the diverse social contexts and processes that shape acceptability, uptake, and long-term use of female barrier methods. Both dyadic interventions targeted to partners and structural interventions targeted to the health care system, including health care workers and policymakers, are urgently needed. Postmarketing research is required to understand the ways in which these methods are used and can be promoted in real-world, non-clinical trial settings. Examples from key successful domestic and international programs will be given. If newer methods, such as microbicides and diaphragms, are proven to be effective for disease prevention, then lessons learned from female condom programming can facilitate their acceptance as alternative barrier methods.
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050612
MR-A0101
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