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RESEARCH ARTICLE

A comparison of young women’s actual and assigned timing of use of a microbicide surrogate

Amanda E. Tanner A E , Katherine A. Roof B , Barry P. Katz C , Adrian Katschke C , J. Dennis Fortenberry D and Gregory D. Zimet D
+ Author Affiliations
- Author Affiliations

A Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC 27401, USA.

B Department of Psychology, University of North Carolina Charlotte, Charlotte, NC 28223, USA.

C Division of Biostatistics, Indiana University School of Medicine, Indianapolis, IN 46202, USA.

D Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.

E Corresponding author. Email: aetanner@uncg.edu

Sexual Health 9(4) 299-303 https://doi.org/10.1071/SH11063
Submitted: 16 April 2011  Accepted: 10 October 2011   Published: 9 January 2012

Abstract

Purpose: This study examined young women’s actual timing of use of a microbicide surrogate gel (vaginal moisturiser (VM)) compared with assigned timing conditions. Methods: Participants used a VM with coitus during 4-week cycles over a 3-year period in random timing sequences: 1 h before coitus, 10 min before coitus and 10 min after coitus. Daily diaries collected information related to coital behaviours, VM use and timing, and participants’ and partners’ VM assessments. Descriptive and mixed-effects model analyses were conducted. Results: At least three VM timing conditions were completed by 109 women aged 18–22 years old. Of 17 772 diary days collected, coitus was reported on 2128 (1252 with VM use; 59%). Median times between VM application and coitus were: 60 min before coitus (mean = 68.2; s.d. = 76.9) for the 1-h pre-coital group, 13.5 min before coitus (mean = 44.9; s.d. = 117.1) for the 10-min pre-coital group and 5 min before coitus (mean = 24.5; s.d. = 205.1) for the 10-min post-coital group. Women reported that the VM was very easy to use (68%), it was somewhat messy (61%), they were very wet during sex (81%), sex was very good (80%) and their partners liked using the VM (38%). Conclusions: Overall, the VM was rated positively. There was substantial deviation in application time across timing conditions, with significantly greater variability in the post-coital group. These findings contribute to understanding of how VMs are accepted and used, with implications for HIV prevention with microbicides requiring specific application timing.

Additional keywords: acceptability, application, HIV prevention, STI prevention, vaginal microbicide.


References

[1]  World Health Organization (WHO). Sexually transmitted infections. Fact sheet 110 [serial online]. Geneva: WHO; 2007.

[2]  US Department of Health and Human Services (USDHHS). Sexually transmitted diseases surveillance, 2007. Atlanta: USDHHS; 2008. Available online at: http://www.cdc.gov/std/stats07/Surv2007FINAL.pdf [verified September 2010].

[3]  Cutler B, Justman J. Vaginal microbicides and the prevention of HIV transmission. Lancet Infect Dis 2008; 8 685–97.
Vaginal microbicides and the prevention of HIV transmission.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD1cXhsVWltr3J&md5=6e8252b845759aa1ae35eb78e5fae5e7CAS | 18992405PubMed |

[4]  Nuttall J, Romano J, Douville K,, Galbreath C, Nel A, Heyward W, et al The future of HIV prevention: prospects for an effective anti-HIV microbicide. Infect Dis Clin North Am 2007; 21 219–39.
The future of HIV prevention: prospects for an effective anti-HIV microbicide.Crossref | GoogleScholarGoogle Scholar | 17502237PubMed |

[5]  Abdool Karim Q, Abdool Karim SS, Frohlich JA, Groeber AC, Baxter C, Monsoor LE, et al Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science 2010; 329 1168–74.
Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3cXhtV2hsr%2FI&md5=8285ce242cb3cffcd596b459dfca99e7CAS | 20643915PubMed |

[6]  Elias C, Coggins C. Acceptability research on female-controlled barrier methods to prevent heterosexual transmission of HIV: where have we been? Where are we going? J Womens Health Gend Based Med 2001; 10 163–73.
Acceptability research on female-controlled barrier methods to prevent heterosexual transmission of HIV: where have we been? Where are we going?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M7mslOrug%3D%3D&md5=f89957f2a33e1af2d8ad3615b274f394CAS | 11268299PubMed |

[7]  Severy LJ, Newcomer S. Critical issues in contraceptive and STI acceptability research. J Soc Issues 2005; 61 45–65.
Critical issues in contraceptive and STI acceptability research.Crossref | GoogleScholarGoogle Scholar |

[8]  Tanner AE, Short M, Zimet GD, Rosenthal SL. Research on adolescents and microbicides: a review. J Pediatr Adolesc Gynecol 2009; 22 285–91.
Research on adolescents and microbicides: a review.Crossref | GoogleScholarGoogle Scholar | 19616456PubMed |

[9]  Behets FM, Turner AN, Van Damme K, Rabenja NL, Ravelomanana N, Swezey T, et al Vaginal microbicide and diaphragm use for sexually transmitted infection prevention: a randomized acceptability and feasibility study among high-risk women in Madagascar. Sex Transm Dis 2008; 35 818–26.
Vaginal microbicide and diaphragm use for sexually transmitted infection prevention: a randomized acceptability and feasibility study among high-risk women in Madagascar.Crossref | GoogleScholarGoogle Scholar | 18562985PubMed |

[10]  Hoffman S, Morrow KM, Mantell JE, Rosen RK, Carballo-Diéguez A, Gal F. Covert use, vaginal lubrication, and sexual pleasure: a qualitative study of urban U.S. women in a vaginal microbicide clinical trial. Arch Sex Behav 2010; 39 748–60.
Covert use, vaginal lubrication, and sexual pleasure: a qualitative study of urban U.S. women in a vaginal microbicide clinical trial.Crossref | GoogleScholarGoogle Scholar | 19636696PubMed |

[11]  Joglekar N, Joshi S, Kakde M, Fang G, Cianciola M, Reynolds S, et al Acceptability of PRO2000 vaginal gel among HIV un-infected women in Pune, India. AIDS Care 2007; 19 817–21.
Acceptability of PRO2000 vaginal gel among HIV un-infected women in Pune, India.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2szlvFKnsQ%3D%3D&md5=442a80b14a2160cd647032dd09cb53fbCAS | 17573603PubMed |

[12]  Rosen RK, Morrow KM, Carballo-Diéguez A, Mantell JE, Hoffman S, Gai F, et al Acceptability of tenofovir gel as a vaginal microbicide among women in a phase I trial: a mixed-methods study. J Womens Health (Larchmt) 2008; 17 383–92.
Acceptability of tenofovir gel as a vaginal microbicide among women in a phase I trial: a mixed-methods study.Crossref | GoogleScholarGoogle Scholar |

[13]  Short MB, Ramos S, Oakes JK, Rosenthal SL. Adolescent girls’ communication with partners about microbicide use. Sex Health 2007; 4 243–8.
Adolescent girls’ communication with partners about microbicide use.Crossref | GoogleScholarGoogle Scholar | 18082067PubMed |

[14]  Sunder PK, Ramos S, Short MB, Rosenthal SL. Adolescent girls’ communication with “mothers” about topical microbicides. J Pediatr Adolesc Gynecol 2006; 19 373–9.
Adolescent girls’ communication with “mothers” about topical microbicides.Crossref | GoogleScholarGoogle Scholar | 17174825PubMed |

[15]  Tanner AE, Zimet GD, Fortenberry JD, Reece M, Graham CA, Murray M. Young women’s use of a vaginal microbicide surrogate: the role of individual and contextual factors in acceptability and sexual pleasure. J Sex Res 2009; 46 15–23.
Young women’s use of a vaginal microbicide surrogate: the role of individual and contextual factors in acceptability and sexual pleasure.Crossref | GoogleScholarGoogle Scholar | 19012060PubMed |

[16]  Tanner AE, Fortenberry JD, Zimet GD, Reece M, Graham CA, Murray M. Young women’s use of a microbicide surrogate: the complex influence of relationship characteristics and perceived male partners’ evaluation. Arch Sex Behav 2010; 39 735–47.
Young women’s use of a microbicide surrogate: the complex influence of relationship characteristics and perceived male partners’ evaluation.Crossref | GoogleScholarGoogle Scholar | 19224355PubMed |

[17]  Zubowicz EA, Oakes JK, Short MB, Perfect MM, Succop PS, Rosenthal SL. Adolescents’ descriptions of the physical characteristics of microbicide surrogates and experiences of use. J Womens Health (Larchmt) 2006; 15 952–61.
Adolescents’ descriptions of the physical characteristics of microbicide surrogates and experiences of use.Crossref | GoogleScholarGoogle Scholar |

[18]  Short MB, Mills L, Majkowski JM, Stanberry LR, Rosenthal SL. Topical microbicide use by adolescent girls: concerns about timing, efficacy, and safety. Sex Transm Dis 2003; 30 854–8.
Topical microbicide use by adolescent girls: concerns about timing, efficacy, and safety.Crossref | GoogleScholarGoogle Scholar | 14603095PubMed |

[19]  Tanner AE, Katzenstein JM, Zimet GD, Cox DS, Cox AD, Fortenberry JD. Vaginal microbicide preferences among Midwestern urban adolescent women. J Adolesc Health 2008; 43 349–56.
Vaginal microbicide preferences among Midwestern urban adolescent women.Crossref | GoogleScholarGoogle Scholar | 18809132PubMed |

[20]  Ramjee G, Morar NS, Braunstein S, Friedland B, Jones H, van de Wijgert J. Acceptability of Carraguard, a candidate microbicide and methyl cellulose placebo vaginal gels among HIV-positive women and men in Durban, South Africa. AIDS Res Ther 2007; 4 1–10.
Acceptability of Carraguard, a candidate microbicide and methyl cellulose placebo vaginal gels among HIV-positive women and men in Durban, South Africa.Crossref | GoogleScholarGoogle Scholar |

[21]  Fortenberry JD, Temkit M, Tu W, Graham CA, Katz BP, Orr DP. Daily mood, partner support, sexual interest, and sexual activity among adolescent women. Health Psychol 2005; 24 252–7.
Daily mood, partner support, sexual interest, and sexual activity among adolescent women.Crossref | GoogleScholarGoogle Scholar | 15898860PubMed |

[22]  Centers for Disease Control and Prevention (CDC). STD surveillance 2008 (complete report). Atlanta: CDC; 2009. Available online at: http://www.cdc.gov/std/stats08/surv2008-Complete.pdf [verified September 2010].

[23]  Ventura SJ, Matthews TJ, Hamilton BE. Teenage births in the United States: state trends, 1991–2000, an update. Natl Health Stat Report 2002; 50 1–4. [serial online]

[24]  Indiana State Department of Health (ISDoH). Spotlight on HIV/STD/viral hepatitis: Indiana semi-annual report. Indianapolis: ISDoH; 2008. Available online at: http://www.in.gov/isdh/24407.htm [verified September 2010].

[25]  R Development Core Team. R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2010.

[26]  Pinheiro J, Bates D, DebRoy D, Sarkar D (R Core team). Nlme: linear and nonlinear mixed effects models. R package version 3. Vienna: R Foundation for Statistical Computing; 2009.

[27]  Hothorn T, Bretz F, Westfall P. Simultaneous inference in general parametric models. Biom J 2008; 50 346–63.
Simultaneous inference in general parametric models.Crossref | GoogleScholarGoogle Scholar | 18481363PubMed |

[28]  Braunstein S, Van de Wijgert J. Preferences and practices related to vaginal lubrication: implications for microbicide acceptability and clinical testing. J Womens Health (Larchmt) 2005; 14 424–33.
Preferences and practices related to vaginal lubrication: implications for microbicide acceptability and clinical testing.Crossref | GoogleScholarGoogle Scholar |

[29]  Philpott A, Knerr W, Maher D. Promoting protection and pleasure: amplifying the effectiveness of barriers against sexually transmitted infections and pregnancy. Lancet 2006; 368 2028–31.
Promoting protection and pleasure: amplifying the effectiveness of barriers against sexually transmitted infections and pregnancy.Crossref | GoogleScholarGoogle Scholar | 17141710PubMed |

[30]  Global Microbicide Campaign (GMC). GC News #122: September 2010. Washington: GMC; 2010. Available online at: http://www.global-campaign.org/GCNews.htm [verified October 2010].