Exploring vaginal ring acceptability for contraception and sexually transmissible infection protection in India: a qualitative research study
Udita Das A , Mamta Sharma A B , Maggie Kilbourne-Brook C and Patricia S. Coffey C DA Delhi, India.
B Deceased.
C PATH, PO Box 900922, Seattle, Washington, 98109, USA.
D Corresponding author. Email: pcoffey@path.org
Sexual Health 12(6) 532-540 https://doi.org/10.1071/SH15045
Submitted: 14 March 2014 Accepted: 17 June 2015 Published: 11 August 2015
Abstract
Background: New vaginal rings are being developed as single and multipurpose prevention technologies to protect women from pregnancy and/or sexually transmissible infections, such as HIV. Data on ring acceptability in low-resource settings is critical for new technologies to meet user needs. Methods: Women from slum and lower-income areas around Delhi, India, participated in focus group discussions on vaginal ring product perceptions and preferences. Participants were recruited based on following eligibility categories: age, marital status, contraceptive use, and number of children. The translated transcriptions of the qualitative data were analysed using a coding scheme generated from the areas of inquiry and relevant literature. Results: A total of 103 women from lower-middle-class or slum areas in Delhi participated in 13 focus group discussions between December 2012 and January 2013. Participants shared perceptions of vaginal ring product attributes, including size, colour, intended use (single indication or dual purpose), duration of use, side effects, biodegradability, and various preferences regarding product use, including access, use during sex, wear patterns, cleaning, and disposal. Participants also reflected on willingness to pay and male partner acceptability. Conclusions: The results of this hypothetical acceptability study indicate that these low-income women in Delhi are: willing to try vaginal rings; unconcerned about wearing them during sex; very interested in protection from infections and unintended pregnancy; indifferent about colour of new rings; emphatic about being told that rings may change colour from menstrual blood staining; comfortable with thinner rings; willing to try thicker rings once familiar with thinner rings; in favour of starting with 1-month rings and then transitioning to longer-term rings; and in favour of first accessing rings at a facility and then managing resupply independently.
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