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Female-controlled HIV prevention methods in Zimbabwe: how “involved” are the primary male partners?
Presented by Elizabeth Montgomery, United States.
Montgomery E.1, Chidanyika A.2, Mtetwa S.2, Purchia E.1, Chipato T.2, Padian N.1, van der Straten A.1, the MIRA study team (Zimbabwe)
1University of California, San Francisco, Women's Global Health Imperative, San Francisco, CA, United States, 2University of Zimbabwe, University of California, San Francisco Collaborative Programme, Harare, Zimbabwe
Objectives: Male partners may influence women’s acceptability and use of female-controlled methods. To better understand this, we conducted a study about male partner involvement among HIV-negative women enrolled into a phase III trial of the diaphragm and gel in Zimbabwe (the MIRA study).
Methods: A structured questionnaire, administered to MIRA participants at months 3 and 12, explored male partner support, communication and health-seeking behaviour. Descriptive indicators of male involvement were summarized using SAS.
Results: Approximately 90% (n=1952) of those eligible participated in the study, evenly distributed across the 2 study arms (diaphragm/gel/condoms and condoms-only). Women reported on their “regular” partner; 98% were husbands. The study population is on average 28, with 9.3 years of education, 1.3 lifetime sexual partners, and 26.5% employment. Despite staff efforts to involve men, only 10% of partners came to the MIRA clinics during the study. In contrast, 80% of women reported he would come if she asked him to. Women reported high levels of discussion with partners about study participation (98%), study procedures (98%) and their HIV/STI results (99%). In the diaphragm/gel arm, almost three-quarters of women openly reminded men about diaphragm/gel use every time they had sex and over 85% reported they had never used products secretly. 95% of women report their partners were overall supportive of diaphragm/gel use and liked/strongly-liked them, and 82% report no difficulty negotiating product use. Two-thirds(67%) of partners had asked about diaphragm comfort and care, and 15% helped women insert/remove the diaphragm or gel applicator.
Conclusions: In this study, women’s perceptions of partner support for study participation and product use were very high, although clinic turn-out among partners was low. Social desirability bias may have influenced women´s self-report of partner participation. Next steps are to correlate male involvement indicators with women’s product adherence, acceptability and disease incidence in multivariate analyses.
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