Microbicides: Information, beliefs, and preferences for insertion

Objectives: Microbicides are products in development to prevent sexually transmitted infection and HIV acquisition; they are not yet available to the public. We evaluated (1) where women would expect to seek information about microbicides, (2) factors that women think might affect microbicide effectiveness, and (3) women's anticipated preferences for timing and place of insertion and partner involvement. Methods: A cross-sectional face-to-face interview was administered to women aged 18-35 years (n = 126) recruited from a gynecology clinic in Galveston, Texas. Women were shown a microbicide surrogate and asked to complete a series of closed-ended questions focusing on demographics, expected sources of information on microbicides, perceived factors related to effectiveness, and preferences for timing and place of insertion and level of partner involvement. Univariate descriptive analyses were used to calculate means, medians, and frequencies. Results: Women's most cited anticipated sources of information for microbicides were physicians (89%), the package insert/box (86%), and pharmacists (70%). Approximately two thirds of the women believed that menstruation or taking other medicines and approximately one third believed that taking a bath/shower before intercourse or after intercourse or using birth control medication could limit effectiveness. Women anticipated preferring to insert the microbicide before intercourse (90%) and while in the bathroom (73%). Most (95%) anticipated telling their partners they planned to use a microbicide, and 38% anticipated having their partner insert the product for them. Conclusions: Women's beliefs about those factors that could limit effectiveness of microbicides should be addressed as part of anticipatory guidance or in the package inserts. Partners likely will be involved in the use of microbicides; thus, education/marketing efforts should also incorporate partner beliefs and preferences.