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Strategies to improve male partner involvement in microbicide research needed
Lesley Odendal, 2014-12-17 11:50:00

Vaginal microbicides were partially developed in response to power differentials within sexual relationships and gender norms that make it difficult for women to negotiate other forms of HIV protection, as it can be used without the male partner’s knowledge, consent or compliance. However, evidence presented at the HIV Research for Prevention conference (R4P) held in Cape Town, South Africa in October suggests that microbicide trial participants usually choose to talk to steady partners about their product use and that male partners’ knowledge and acceptance of microbicide use promoted product acceptability and self-reported adherence to microbicide regimens among women. Women in several microbicide trials also reported that involving their male partners in microbicide use benefited their relationships, including improving communication and relationship quality and increasing shared responsibility for HIV protection.

“Constructively engaging male partners in women- centered health programs such as family planning and PMTCT has resulted in both improved health and relationship outcomes. Concerted efforts to engage men in women’s microbicide use for HIV prevention could make it easier for women to access and use microbicides, if an effective product is identified”, said Dr Elizabeth Montgomery from RTI International who conducted primary and secondary analyses of male engagement data from six qualitative studies implemented in conjunction with microbicide trials in South Africa, Kenya and Tanzania (MDP 301, Carraguard, VOICE, Adolescents and Microbicides Trials and IPM 014a, IPM 015, VivaGel) . The analyses included 535 interviews and 107 focus groups with trial participants, male partners, and community members. The findings across the studies were synthesised and recommendations for future research and microbicide introduction were developed.

The analyses found that women used different strategies to gain partner approval, such as using the product for a while before telling their partner, giving partner information about trial participation or microbicides gradually or continuing to bring up microbicides in conversation.

Among men who were aware of their partner’s microbicide use, involvement ranged from opposition to agreement or non-interference to active support. Both men and women expressed a desire for men to have access to information about microbicides. Some of the men and women stated that it would be helpful if male partners could talk with a health provider about microbicides, but men were often hesitant to go to the clinic during the trials because of their work schedules, fear of HIV testing, and stigma.

The effect of men on the participation of women in microbicide research was illustrated in the VOICE-D study presented at the conference. 30% (n=139) of sensitised and pre-screened presumptively eligible women in Uganda stated that their reason for never attending trial sessions was because they had no income and feared losing financial support from their male partners. The women who missed initial screening visits stated this was due to their male partners’ refusal or fear of their reaction.