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Preparing for microbicide introduction: A qualitative study in South Africa

Jane Harries, MPhil1, Phyllis Orner, MA MPhil1, Diane Cooper, PhD1, Jennifer Moodley, MBCHB MMed1, Margaret Hoffman, MBCHB DCommMed1, Julie Becker, ScM2, Rasha Dabash, MPH3, Elizabeth McGrory, ScM4, and Hillary Bracken, MHS, MA5. (1) Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa, 27 21 406 6798, jharries@cormack.uct.ac.za, (2) Senior Program Manager, Country and Regional Programs, International AIDS Vaccine Initiative (IAVI), 110 William Street, 27th Floor, New York, NY 10038, (3) EngenderHealth, 2603 Centinela Avenue # B, Santa Monica, CA 90405, (4) Director of Access, International Partnership for Microbicides, 1010 Wayne Avenue, Suite 520, Silver Spring, MD 20910, (5) Population Council, 1 Dag Hammarskjold Plaza, New York, NY 10017

Background: HIV prevention strategies are limited as women’s risk is frequently derived from their partners’ behaviors, rather than their own. Microbicides may offer the possibility of reducing women’s risk of HIV/STIs in cases where other more effective methods cannot be used. An environment conducive to introducing microbicides is critical to avoid some of the obstacles that have historically inhibited similar technological innovations. The research presented aims to inform microbicide introduction strategies. Methods: Qualitative research was conducted at three levels: community, service provider and policymakers. Focus group discussions and in-depth interviews were held at community and service provider level in a community in Cape Town, South Africa. In depth interviews were held with policy makers and key policy influentials at national and provincial levels. Data analysis was conducted using a grounded theory approach. Results: Respondents expressed keen support for microbicides, underscored by desperation related to the epidemic and recognition of women’s vulnerability. Key findings include: microbicide’s perceived impact on sexual relations and gender norms; implications for intravaginal practices; concerns regarding fertility, and the possibility of using a microbicide in the event of rape or unplanned sex; how the concepts of harm reduction and partial effectiveness were understood; who might hinder or facilitate introduction; potential users; information and counseling needs and suggested product delivery points. Conclusions: The findings assist in identifying potential barriers and facilitating factors towards microbicides that will contribute towards informing their further development and creating an environment conducive towards their introduction, should they become an approved HIV prevention method.

Learning Objectives: At the end of the session the participants will be able to

Keywords: HIV/AIDS, Prevention

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

HIV/AIDS in Africa and Its Ramifications

The 132nd Annual Meeting (November 6-10, 2004) of APHA