ABSTRACT
BACKGROUND: Along with efficacy, a microbicide's acceptability will be integral to its impact on the pandemic. Understanding Product Characteristics that users find most acceptable and determining who will use which type of product are key to optimizing use effectiveness. OBJECTIVES: To evaluate psychometrically the Important Microbicide Characteristics (IMC) instrument and examine its relationship to willingness to use microbicides. RESULTS: Exploratory and confirmatory factor analyses revealed 2 IMC subscales (Cronbach's coefficient alpha: Product Characteristics subscale (alpha = 0.84) and Protective Properties subscale (alpha = 0.89)). Significant differences on Product Characteristics subscale scores were found for history of douching (P = 0.002) and employment status (P = 0.001). Whether a woman used a method to prevent pregnancy or sexually transmitted disease (STD) in the last 3 months (P < 0.001) and whether she used a condom during the last vaginal sex episode (P < 0.001) were significantly related to her rating of the importance of microbicides being contraceptive. Product Characteristics (r = 0.21) and Protective Properties (r = 0.27) subscale scores and whether a microbicide had contraceptive properties (r = 0.24) were all significantly associated (P < 0.001) with willingness to use microbicides. CONCLUSIONS: Formulation and use characteristics and product function(s) affect willingness to use microbicides and should continue to be addressed in product development. The IMC instrument serves as a template for future studies of candidate microbicides.
Subject(s)
Anti-Infective Agents, Local/supply & distribution , Attitude to Health/ethnology , Health Behavior/ethnology , Motivation , Sexually Transmitted Diseases , Administration, Intravaginal , Adolescent , Adult , Black or African American/statistics & numerical data , Anti-Infective Agents, Local/administration & dosage , Anti-Infective Agents, Local/classification , Consumer Behavior/statistics & numerical data , Contraception Behavior/ethnology , Contraception Behavior/statistics & numerical data , Cross-Sectional Studies , Female , HIV Infections/prevention & control , Hispanic or Latino/statistics & numerical data , Humans , Likelihood Functions , Male , Middle Aged , Principal Component Analysis , Reproducibility of Results , Sexual Behavior/psychology , Sexual Behavior/statistics & numerical data , Sexual Partners , Sexually Transmitted Diseases/epidemiology , Sexually Transmitted Diseases/prevention & control , Sexually Transmitted Diseases/psychology , Surveys and Questionnaires , United States/epidemiology , Vaginal Creams, Foams, and Jellies/administration & dosage , Vaginal Creams, Foams, and Jellies/classification , Vaginal Creams, Foams, and Jellies/supply & distribution , White People/statistics & numerical dataABSTRACT
The first candidate topical microbicides--products designed to reduce women's risk of HIV infection--are now in the final stages of efficacy testing, and, if successful, could start to be available by the end of the decade. Advocates in public health and international development are already discussing how to expedite access to this new technology in countries where it could have the largest public health impact. The World Health Organization (WHO), World Bank, and the European Union support the integration of family planning and HIV programs. Such integration is impeded by U.S. policy, funding restrictions, and reluctance to integrate family planning and HIV/AIDS funding. This article describes how these policies weaken, rather than strengthen, the capacity of distribution networks to play an urgently needed role in microbicide roll-out when the time comes.
