Researchers Investigate Acceptability of Potential HIV Prevention Device in Africa

For some women in the poorest parts of the Kenyan capital of Nairobi, being paid for sex is one of the few ways they are able to feed themselves and their children. In a region hit hard by the HIV/AIDS pandemic, they are at very high risk for contracting the disease.

Georgia State University researchers recently investigated whether these women, and their male clients, would accept a potential method of preventing HIV/AIDS which allows women to take control of their own health.

The device, an intravaginal ring containing chemicals microbicides, has the potential to let women reduce their risk of contracting the disease in an environment where many of their clients refuse to use condoms.

“This group of women are really stressed, and are often supporting children,” said Donna Smith, a research associate with the Georgia State Institute of Public Health. “These are not women who are making a decent living. They’re just getting by and just one client walking away could be the difference between eating or not.”

Working with colleagues such as Frances Priddy of Emory University, as well as Sabina Wakasiaka and the late Job Joab Bwayo of Kenya AIDS Vaccine Initiative, Smith and data coordinator Tina Hoang asked questions among female sex workers in the Nairobi slum community of Mukuru.

Scientists are working to develop microbicides which reduce the spread of HIV, and several types which could be used by women are in development. None have been found yet which have been proven effective in reducing the transmission of HIV/AIDS, but it is believed that an effective one will be developed in the future before a vaccine becomes available, Smith said.
An intravaginal ring, similar to the NuvaRing used currently for birth control in developed countries, could be used to release the microbicide, allowing women to potentially use the device without their partner becoming aware of it.

In the qualitative study published in the Journal of Women’s Health, some women reported that they were comfortable with the idea of using the ring without letting their partner know, however, some of the male clients insisted on knowing that it was being used — and that if they became aware of the device, they would not pay or would pay less.

Overall, though, those participating in the focus group research, sponsored by the CDC Foundation, were open to the use of the ring.

“This should be your secret,” one woman responded. “You don’t need to tell him. You would be protecting yourself from those who want to infect you.”

Smith and Hoang are also working on a six-month cohort study to track rates of STD infection among sex workers, which will help give future microbicide and vaccine researchers more knowledge about high-risk populations.

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