Feasibility and potential acceptability of three cervical barriers among vulnerable young women in Zimbabwe

Background We explored the potential acceptability of three cervical barriers (CB) (Ortho All-Flex® diaphragm, SILCS® diaphragm, FemCapTM cervical cap) among sexually experienced Zimbabwean young women. Methods Forty-five young women (aged 16–21 years) received an individual CB educational session. Participants were then randomly assigned to one of the three CBs in a 1:1:1 ratio, and practised insertion and removal of their device at the clinic. Next, participants were interviewed on their practice experiences, and their post-practice attitudes towards CB. Results All 45 young women were willing and able to insert their assigned device. The majority reported “easy” insertion and removal and 93% “liked” the device they tried. All showed interest in participating in future CB studies: when asked which device they would like to try in the future, over half (58%) chose SILCS, regardless of the device they had tried. The majority felt comfortable touching their genitals to insert/remove the CB and most participants favoured methods' attributes associated with female-control and non-interference with sex. Over half the participants said they would prefer to use a CB continuously compared to episodic use. Two-thirds of them expressed interest in CB for dual protection. Conclusion The concept of CB, and initial insertion experience, were well accepted in this selected, small group of Zimbabwean young women. Evaluating CB in larger studies seems feasible in this population.

[1]  M. Gissler,et al.  The Reproductive Health Report: The state of sexual and reproductive health within the European Union , 2011, The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception.

[2]  J. Geddes,et al.  What is a randomised controlled trial? , 2009, Epidemiologia e Psichiatria Sociale.

[3]  E. Bukusi,et al.  Sexuality, HIV risk and potential acceptability of involving adolescent girls in microbicide research in Kisumu, Kenya. , 2008, Sexual health.

[4]  V. Brache,et al.  Comparative acceptability of the SILCS and Ortho ALL-FLEX diaphragms among couples in the Dominican Republic. , 2008, Contraception.

[5]  A. van der Straten,et al.  The Diaphragm and Lubricant Gel for Prevention of Cervical Sexually Transmitted Infections: Results of a Randomized Controlled Trial , 2008, PloS one.

[6]  D. Celentano,et al.  The role of men in women's acceptance of an intravaginal gel in a randomized clinical trial in Blantyre, Malawi: a qualitative and quantitative analysis , 2008, AIDS care.

[7]  T. Raine,et al.  Adolescent experiences with the vaginal ring. , 2008, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[8]  S. Lees,et al.  The role of partnership dynamics in determining the acceptability of condoms and microbicides , 2008, AIDS care.

[9]  A. van der Straten,et al.  Consistent use of a combination product versus a single product in a safety trial of the diaphragm and microbicide in Harare, Zimbabwe. , 2008, Contraception.

[10]  C. Woodsong,et al.  Sexual pleasure, gender power and microbicide acceptability in Zimbabwe and Malawi. , 2008, AIDS education and prevention : official publication of the International Society for AIDS Education.

[11]  D. Serwadda,et al.  Biomedical interventions to prevent HIV infection: evidence, challenges, and way forward , 2008, The Lancet.

[12]  A. Turner,et al.  Evidence-Based Planning of a Randomized Controlled Trial on Diaphragm Use for Prevention of Sexually Transmitted Infections , 2008, Sexually transmitted diseases.

[13]  C. Mauck,et al.  A Phase I study of the functional performance, safety and acceptability of the BufferGel Duet. , 2008, Contraception.

[14]  S. Luchters,et al.  Secrecy, disclosure and accidental discovery: Perspectives of diaphragm users in Mombasa, Kenya , 2008, Culture, health & sexuality.

[15]  M. Glymour,et al.  Diaphragms and lubricant gel for prevention of HIV , 2007, The Lancet.

[16]  N. Jewell,et al.  Diaphragms and lubricant gel for prevention of HIV – Authors' reply , 2007, The Lancet.

[17]  A. van der Straten,et al.  A randomized controlled safety trial of the diaphragm and cellulose sulfate microbicide gel in sexually active women in Zimbabwe. , 2007, Contraception.

[18]  N. Jewell,et al.  Diaphragm and lubricant gel for prevention of HIV acquisition in southern African women: a randomised controlled trial , 2007, The Lancet.

[19]  S. Luchters,et al.  Acceptability of the diaphragm in Mombasa Kenya: A 6-month prospective study , 2007, The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception.

[20]  S. Posner,et al.  Sex preparation and diaphragm acceptability in sex work in Nairobi, Kenya. , 2006, Sexual health.

[21]  P. Coffey,et al.  Short-term acceptability of the PATH Woman's Condom among couples at three sites. , 2006, Contraception.

[22]  C. Mauck,et al.  SILCS Diaphragm: Postcoital Testing of a New Single-Size Contraceptive Diaphragm* , 2006 .

[23]  D. Weiner,et al.  FemCap with removal strap: ease of removal, safety and acceptability. , 2006, Contraception.

[24]  A. Quayle,et al.  Immunological Microenvironments in the Human Vagina and Cervix: Mediators of Cellular Immunity Are Concentrated in the Cervical Transformation Zone1 , 2005, Biology of reproduction.

[25]  A. Turner,et al.  Acceptability and feasibility of continuous diaphragm use among sex workers in Madagascar , 2005, Sexually Transmitted Infections.

[26]  S. Posner,et al.  Barrier Method Preferences and Perceptions Among Zimbabwean Women and their Partners , 2005, AIDS and Behavior.

[27]  A. van der Straten,et al.  Predictors of Diaphragm Use as a Potential Sexually Transmitted Disease/HIV Prevention Method in Zimbabwe , 2005, Sexually transmitted diseases.

[28]  H. Rees,et al.  Sexual Power and HIV Risk, South Africa , 2004, Emerging infectious diseases.

[29]  N. Michael,et al.  Joint United Nations Programme on HIV/AIDS. , 2004, Military medicine.

[30]  S. Rosenthal,et al.  Vaginal microbicides and teenagers , 2003, Current opinion in obstetrics & gynecology.

[31]  L. Beckman,et al.  Who continues using the diaphragm and who doesn't: implications for the acceptability of female-controlled HIV prevention methods. , 2003, Women's health issues : official publication of the Jacobs Institute of Women's Health.

[32]  K. Barnhart,et al.  Magnetic resonance imaging to determine the distribution of a vaginal gel: before, during, and after both simulated and real intercourse. , 2002, Contraception.

[33]  S. Farr,et al.  Reducing unplanned pregnancy and abortion in Zimbabwe through postabortion contraception. , 2002, Studies in family planning.

[34]  R. Anderson,et al.  For Personal Use. Only Reproduce with Permission from the Lancet Publishing Group , 2022 .

[35]  N. Padian,et al.  Preventing disease by protecting the cervix: the unexplored promise of internal vaginal barrier devices , 2001, AIDS.

[36]  P. Sow,et al.  To stem HIV in Africa, prevent transmission to young women. , 2001, AIDS.

[37]  M. Brady,et al.  Assessing the acceptability, service delivery requirements, and use-effectiveness of the diaphragm in Colombia, Philippines, and Turkey. , 2001, Contraception.

[38]  D. Weiner,et al.  A comparative study of the safety and efficacy of FemCap, a new vaginal barrier contraceptive, and the Ortho All-Flex diaphragm. The FemCap Investigators' Group. , 1999, Contraception.

[39]  L. Zaneveld,et al.  Women's preferences for vaginal antimicrobial contraceptives. II. Preferred characteristics according to women's age and socioeconomic status. , 1998, Contraception.

[40]  Shihata Aa The FemCap: a new contraceptive choice , 1998 .

[41]  L. Stanberry,et al.  Topical Microbicides: Current Status and Research Considerations for Adolescent Girls , 1998, Sexually transmitted diseases.

[42]  A. Shihata The FemCap: a new contraceptive choice. , 1998, The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception.

[43]  K. Beck,et al.  Development and validation of a condom self-efficacy scale for college students. , 1991, Journal of American college health : J of ACH.

[44]  Z. Stein,et al.  HIV prevention: the need for methods women can use. , 1990, American journal of public health.

[45]  G. Francis Preventing Disease , 1877, Nature.