Microbicide gels are acceptable to most women during sex, the results of three studies presented today at the M2010 Microbicides conference showed.
Microbicides are substances, like gels, designed to stop HIV or other sexually-transmitted infections when applied topically inside the vagina or rectum.
Significantly the one study showed that the male partner’s willingness to accept the gel was a more accurate indication of whether women would use it than whether they thought it was effective at stopping HIV.
“The gel’s acceptability was most strongly influenced by a partner’s willingness, even more than her own,” said Sharon Abbott from the Population Council in New York, whose research included information from South Africa trial sites.
“Gender and sexual norms were a better predictor of use than belief in efficacy,” said Abbott, who was assessing the acceptability of Carraguard among women.
Two gels (PRO 2000 and BUFFERGEL) evaluated in another study had about 99% acceptability.
The researcher Nicola Coumi from the Medical Research Council said that nearly half (43%) of the women expressed three or more likes, and only 3% expressed two or more dislikes of these products.
Adherence – using the gel as intended – is higher among the women who expressed positive views (several ‘likes’).
Adherence was also higher among older women, married women, those with a higher education and those who reported male condom use and douching before the start of the trial.
And roughly a fifth of the women in the MRC study found that the gels made sex more pleasurable (22% to 24%).
In another study where most participants were formal or informal sex workers, the women particularly liked the lubricant properties of the gel being tested (CONRAD’S cellulose sulfate 6%).
One woman in India even told the researchers, led by Elizabeth Green from Family Health International, that it allowed her to have more clients a day and thus earn more money.
These women suggested the gel reduced pain and reduced condom breakage.
They liked to use the product with casual partners but did not find it appropriate for their boyfriends or husbands since they thought it might ruin intimacy and trust.
“Most women liked the gel but contextual, interpersonal factors (relationships) had a stronger influence on its actual use,” Green said.
The encouraging results from Abbott’s research were that the women’s partners mostly liked it, it was easy to use during sex and when sex was routine or expected.
On the down side, it was less acceptable during a second round of sex, when partners disliked it, when sex was spontaneous or the women were away from home.
The sex acts covered ranged from 39% to 79% in this study but a biomarker (a stain on the applicator showing it was vaginally inserted) revealed that the gel was used less frequently than the women had claimed.
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