Skip to main content

Advertisement

Log in

Disclosure of Microbicide Gel Use to Sexual Partners: Influence on Adherence in the CAPRISA 004 Trial

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Young women in sub-Saharan Africa are disproportionately affected by HIV, making the development of women initiated and controlled methods of prevention, including microbicides, a priority. Adherence is pivotal to microbicide efficacy and partner related factors are known to impact adherence. An analysis of disclosure of gel use to sexual partners and adherence in CAPRISA 004 women was conducted to better understand this relationship. Partner disclosure was significantly associated with a modest 4.2 % increased adherence (71.0 vs. 66.8 %, p = 0.03). Most women rated the experience of disclosure as positive, despite 6.7 % of partners expressing a negative reaction.Participants who disclosed were more likely to reside with their regular partner (14.4 vs. 8.4 %; p = 0.01) and reported consistent condom use at baseline (32.9 vs. 20.9 %; p < 0.01). Partner disclosure needs to be better understood as a potential facilitator or barrier to microbicide adherence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. UNAIDS. World AIDS Day Report. 2012. www.un.org/en/events/aidsday/2012/report.shtm. Accessed 13 March 2013.

  2. Stein ZA. HIV prevention: the need for methods women can use. Am J Public Health. 1990;80(4):460–2.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Abdool Karim Q, Abdool Karim SS, Frohlich JA, Grobler AC, Baxter C, LE Mansoor, et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010;329(5996):1168–74.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Karim SS, Kashuba AD, Werner L, Karim QA. Drug concentrations after topical and oral antiretroviral pre-exposure prophylaxis: implications for HIV prevention in women. Lancet. 2011;378(9787):279–81.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Stirratt M, Gordon C. Adherence to biomedical HIV prevention methods: considerations drawn from HIV treatment adherence research. Curr HIV/AIDS Rep. 2008;5(4):186–92.

    Article  PubMed  Google Scholar 

  6. Van Damme L, Corneli A, Ahmed K, Agot K, Lombaard J, Kapiga S, et al. Preexposure prophylaxis for HIV infection among African women. N Engl J Med. 2012;367(5):411–22.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Kharsany AB, Karim QA, Karim SS. Uptake of provider-initiated HIV testing and counseling among women attending an urban sexually transmitted disease clinic in South Africa: missed opportunities for early diagnosis of HIV infection. AIDS Care. 2010;22(5):533–7.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Kharsany AB, Hancock N, Frohlich JA, Humphries HR, Abdool Karim SS, Abdool Karim Q. Screening for ‘window-period’ acute HIV infection among pregnant women in rural South Africa. HIV Med. 2010;11(10):661–5.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Carballo-Dieguez A, Balan IC, Morrow K, Rosen R, Mantell JE, Gai F, et al. Acceptability of tenofovir gel as a vaginal microbicide by US male participants in a Phase I clinical trial (HPTN 050). AIDS Care. 2007;19(8):1026–31.

    Article  PubMed  Google Scholar 

  10. Greene E, Batona G, Hallad J, Johnson S, Neema S, Tolley EE. Acceptability and adherence of a candidate microbicide gel among high-risk women in Africa and India. Cult Health Sex. 2010;12(7):739–54.

    Article  PubMed  Google Scholar 

  11. Montgomery ET, Cheng H, van der Straten A, Chidanyika AC, Lince N, Blanchard K, et al. Acceptability and use of the diaphragm and Replens lubricant gel for HIV prevention in Southern Africa. AIDS Behav. 2010;14(3):629–38.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Montgomery ET, van der Straten A, Chidanyika A, Chipato T, Jaffar S, Padian N. The importance of male partner involvement for women’s acceptability and adherence to female-initiated HIV prevention methods in Zimbabwe. AIDS Behav. 2011;15(5):959–69.

    Article  PubMed Central  PubMed  Google Scholar 

  13. van der Straten A, Kang MS, Posner SF, Kamba M, Chipato T, Padian NS. Predictors of diaphragm use as a potential sexually transmitted disease/HIV prevention method in Zimbabwe. Sex Transm Dis. 2005;32(1):64–71.

    Article  PubMed  Google Scholar 

  14. Microbicide Trials Network. Daily HIV prevention approaches didn’t work for Arican women in the voice study [press release], Atlanta, March 4 2013.

  15. Berger RE. Re: preexposure chemoprophylaxis for HIV prevention in men who have sex with men. J Urol. 2011;185(5):1729–30.

    Google Scholar 

  16. Montgomery CM, Gafos M, Lees S, Morar NS, Mweemba O, Ssali A, et al. Re-framing microbicide acceptability: findings from the MDP301 trial. Cult Health Sex. 2010;12(6):649–62.

    Article  PubMed  Google Scholar 

  17. Turner AN, De Kock AE, Meehan-Ritter A, Blanchard K, Sebola MH, Hoosen AA, et al. Many vaginal microbicide trial participants acknowledged they had misreported sensitive sexual behavior in face-to-face interviews. J Clin Epidemiol. 2009;62(7):759–65.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We pay tribute to the women who participated in this trial; their dedication and commitment made this study possible. The CAPRISA 004 Tenofovir Gel trial is supported by the Centre for the AIDS Program of Research in South Africa (CAPRISA), the United States Agency for International Development (USAID), Family Health International (FHI) (Cooperative agreement # GPO-A-00-05-00022-00, Contract # 132119), and LIFElab, a biotechnology center of the South African Department of Science and Technology. Support from CONRAD for the product manufacturing and packaging as well as support from Gilead Sciences for the Tenofovir used in the production of gel is gratefully acknowledged. We thank the US National Institutes for Health’s Comprehensive International Program of Research on AIDS (CIPRA Grant # AI51794) and the Columbia University-Southern African Fogarty AIDS International Training and Research Programme (AITRP Grant # D43TW00231) for the research infrastructure and training that made this trial possible).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kathryn Therese Mngadi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mngadi, K.T., Maarschalk, S., Grobler, A.C. et al. Disclosure of Microbicide Gel Use to Sexual Partners: Influence on Adherence in the CAPRISA 004 Trial. AIDS Behav 18, 849–854 (2014). https://doi.org/10.1007/s10461-014-0696-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-014-0696-0

Keywords

Navigation