Intravaginal practices and microbicide acceptability in Papua New Guinea: implications for HIV prevention in a moderate-prevalence setting

Vallely, Andrew, Fitzgerald, Lisa, Fiya, Voletta, Aeno, Herick, Kelly, Angela, Sauk, Joyce, Kupul, Martha, Neo, James, Millan, John, Siba, Peter and Kaldor, John M. (2012) Intravaginal practices and microbicide acceptability in Papua New Guinea: implications for HIV prevention in a moderate-prevalence setting. BMC Research Notes, 5 613.1-613.31. doi:10.1186/1756-0500-5-613


Author Vallely, Andrew
Fitzgerald, Lisa
Fiya, Voletta
Aeno, Herick
Kelly, Angela
Sauk, Joyce
Kupul, Martha
Neo, James
Millan, John
Siba, Peter
Kaldor, John M.
Total Author Count Override 11
Title Intravaginal practices and microbicide acceptability in Papua New Guinea: implications for HIV prevention in a moderate-prevalence setting
Journal name BMC Research Notes   Check publisher's open access policy
ISSN 1756-0500
Publication date 2012-11
Sub-type Article (original research)
DOI 10.1186/1756-0500-5-613
Open Access Status DOI
Volume 5
Start page 613.1
End page 613.31
Total pages 31
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2013
Language eng
Formatted abstract
Background: The acceptability of female-controlled biomedical prevention technologies has not been established in Papua New Guinea, the only country in the Pacific region experiencing a generalised, moderate-prevalence HIV epidemic. Socio-cultural factors likely to impact on future product uptake and effectiveness, such as women?s ability to negotiate safer sexual choices, and intravaginal hygiene and menstrual practices (IVP), remain unclear in this setting.

Methods
: A mixed-method qualitative study was conducted among women and men attending a sexual health clinic in Port Moresby. During in-depth interviews, participants used copies of a hand-drawn template to indicate how they wash/clean the vulva and/or vagina. Interviewers pre-filled commercially available vaginal applicators with 2-3mL KY Jelly? to create a surrogate vaginal microbicide product, which was demonstrated to study participants.

Results
: A total of 28 IDIs were conducted (women=16; men=12). A diverse range of IVP were reported. The majority of women described washing the vulva only with soap and water as part of their daily routine; in preparation for sex; and following sexual intercourse. Several women described cleaning inside the vagina using fingers and soap at these same times. Others reported cleaning inside the vagina using a hose connected to a tap; using vaginal inserts, such as crushed garlic; customary menstrual `steaming? practices; and the use of material fragments, cloth and newspaper to absorb menstrual blood. Unprotected sex during menstruation was common. The majority of both women and men said that they would use a vaginal microbicide gel for HIV/STI protection, should a safe and effective product become available. Microbicide use was considered most appropriate in `high-risk? situations, such as sex with non-regular, transactional or commercial partners. Most women felt confident that they would be able to negotiate vaginal microbicide use with male sexual partners but if necessary would be prepared to use product covertly.

Conclusions: Notional acceptability of a vaginal microbicide gel for HIV/STI prevention was high among both women and men. IVP were diverse in nature, socio-cultural dimensions and motivators. These factors are likely to impact on the future acceptability and uptake of vaginal microbicides and other biomedical HIV prevention technologies in this setting.
Keyword Vaginal microbicide
Acceptability
HIV prevention
Papua New Guinea
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article number 613.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Public Health Publications
 
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Created: Tue, 08 Jan 2013, 15:40:04 EST by Geraldine Fitzgerald on behalf of School of Public Health