Factors influencing young women's use of a microbicide proxy

Background: Vaginal microbicides are woman-controlled methods of sexually transmitted infection [STI] prevention. High STI rates make young women an important focus for microbicide research. However, little remains known about the factors that may influence young women's perceptions and use of microbicides. Methodology: In-depth interviews were conducted with 40 young women (18-23 years old; 85% African American; 47.5% mothers) following use of a microbicide surrogate [vaginal moisturizer (VM)] during coital events over 30 days. Interviews were digitally recorded, transcribed verbatim and managed using Atlas ti 5.0. Content analysis identified salient themes related to VM use and non-use. Results: Two main factors emerged from the data. The first factor, Personal Characteristics, included individual issues influencing VM use, for instance VM assessment with the majority of the women (n = 32, 80%) evaluating the VM as neutral or positive. The second factor, Ecological Variables, included issues related to important others, for example sexual partners. Partner perceptions and relationship quality impacted women's use of the moisturizer. Almost half (n = 13, 43.3%) of male partners' evaluated the VM positively which increased VM use. Covert VM use was more common in casual than established relationships. Conclusions: The data suggest that young women's use of vaginal microbicides will be influenced by both internal and contextual factors; therefore they may not fulfill the need for woman-controlled STI prevention method. The complex power and gender structures often exhibited in young women's relationships will need to be considered as public health professionals develop microbicide marketing and education campaigns.