Microbicide Acceptability Among High-Risk Urban U.S. Women: Experiences and Perceptions of Sexually Transmitted HIV Prevention

In Brief Objectives: The objectives of this study were to measure microbicide acceptability among high-risk women in Hartford, Connecticut, and contextual factors likely to affect acceptability and use. Goal: The goal of this study was to assess usefulness of microbicides for HIV/sexually transmitted infection (STI) prevention for high-risk women. Study: Ethnographic interviews (n = 75) and a survey (n = 471) explored women’s perspectives on HIV/STI prevention, vaginal contraceptives similar to microbicides, and microbicide acceptability. Participants (n = 94) in a 2-week behavioral trial used an over-the-counter vaginal moisturizer to simulate microbicide use during sex with primary, casual, and/or paying partners. Results: Findings showed limited experience with vaginal contraceptives, but high interest in microbicides as an alternative to condoms, indicated by an acceptability index score of 2.73 (standard deviation, 0.49; scale of 1–4) in the overall sample. General microbicide acceptability varied by ethnicity, prior contraceptive and violence/abuse experiences, relationship power, and other attitudinal factors. The simulation trial indicated significant willingness to use the product in various locations and with all types of partners. Conclusions: Vaginal microbicides may improve prevention outcomes for high-risk inner-city women. A study of microbicide acceptability among high-risk black, Puerto Rican, non-Hispanic white, and other women in Hartford, Connecticut, indicated limited experience with vaginal contraceptives but significant interest in and willingness to adopt vaginal microbicides for HIV/sexually transmitted infection prevention.