The role of partnership dynamics in determining the acceptability of condoms and microbicides

C. Montgomery; S. Lees; J.J. Stadler; N.S. Morar; A. Ssali; B. Mwanza; M. Ntambo; J. Phillip; R. Pool

doi:10.1080/09540120701693974

The role of partnership dynamics in determining the acceptability of condoms and microbicides

C. Montgomery, S. Lees, J.J. Stadler, N.S. Morar, A. Ssali, B. Mwanza, M. Ntambo, J. Phillip, R. Pool

Sociology

Research output: Contribution to journal › Article › peer-review

Abstract

Microbicides are a class of substances under development that could reduce the sexual transmission of HIV and other sexually transmitted diseases when applied locally to genital mucosal surfaces. Microbicide acceptability research has largely focused on product characteristics, rather than processes of negotiation within relationships about use. Gender relations, decision-making power and communication within sexual relationships are recognised as important determinants of condom and contraceptive use, and are likely to determine microbicide use also. As part of social science research linked to the Microbicides Development Programme (MDP) we combine relationship-based theories with anthropological work conducted with women and men using a placebo gel. We explore communication and decision-making in gel and condom use, including constructions of risk and trust. During the MDP301 Phase III pilot study, in-depth interviews were conducted at sites in South Africa, Tanzania, Uganda and Zambia. Following four weeks of placebo gel use, women and their partners were asked about gel use and acceptability, partner involvement, sexual practices and condom use. Data from 45 couples at five sites were analysed using a grounded theory approach in NVivo. Participation in the study did not require women to inform their partners, yet our data shows women seeking permission from their partners, negotiating disclosure, exchanging information and persuading or motivating for gel use. Although gel was supposedly 'woman-controlled', men exercised considerable influence in determining whether and how it was used. Despite this, negotiations around use were largely successful, since the gel increased sexual pleasure and provided opportunities for intimate communication and the building of trust. Decisions about condom and microbicide use are made in a dyadic context and involve a complex negotiation of risk and trust. Whilst preferences relating to product characteristics are largely individual, use itself is dependent on partnership dynamics and the broader social context in which sexual risk management occurs.

Original language	English
Pages (from-to)	733-740
Number of pages	8
Journal	AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV
Volume	20
Issue number	6
DOIs	https://doi.org/10.1080/09540120701693974
Publication status	Published - Jul 2008

Keywords

sub-Saharan Africa
microbicides
condoms
HIV prevention
gender
SEXUAL DECISION-MAKING
VAGINAL MICROBICIDE
RISK
HIV
WOMEN
COMMUNICATION
POWER
CONSTRUCTION
ADOLESCENTS
STRATEGIES

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10.1080/09540120701693974

Cite this

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title = "The role of partnership dynamics in determining the acceptability of condoms and microbicides",

abstract = "Microbicides are a class of substances under development that could reduce the sexual transmission of HIV and other sexually transmitted diseases when applied locally to genital mucosal surfaces. Microbicide acceptability research has largely focused on product characteristics, rather than processes of negotiation within relationships about use. Gender relations, decision-making power and communication within sexual relationships are recognised as important determinants of condom and contraceptive use, and are likely to determine microbicide use also. As part of social science research linked to the Microbicides Development Programme (MDP) we combine relationship-based theories with anthropological work conducted with women and men using a placebo gel. We explore communication and decision-making in gel and condom use, including constructions of risk and trust. During the MDP301 Phase III pilot study, in-depth interviews were conducted at sites in South Africa, Tanzania, Uganda and Zambia. Following four weeks of placebo gel use, women and their partners were asked about gel use and acceptability, partner involvement, sexual practices and condom use. Data from 45 couples at five sites were analysed using a grounded theory approach in NVivo. Participation in the study did not require women to inform their partners, yet our data shows women seeking permission from their partners, negotiating disclosure, exchanging information and persuading or motivating for gel use. Although gel was supposedly 'woman-controlled', men exercised considerable influence in determining whether and how it was used. Despite this, negotiations around use were largely successful, since the gel increased sexual pleasure and provided opportunities for intimate communication and the building of trust. Decisions about condom and microbicide use are made in a dyadic context and involve a complex negotiation of risk and trust. Whilst preferences relating to product characteristics are largely individual, use itself is dependent on partnership dynamics and the broader social context in which sexual risk management occurs.",

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author = "C. Montgomery and S. Lees and J.J. Stadler and N.S. Morar and A. Ssali and B. Mwanza and M. Ntambo and J. Phillip and R. Pool",

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T1 - The role of partnership dynamics in determining the acceptability of condoms and microbicides

AU - Montgomery, C.

AU - Lees, S.

AU - Stadler, J.J.

AU - Morar, N.S.

AU - Ssali, A.

AU - Mwanza, B.

AU - Ntambo, M.

AU - Phillip, J.

AU - Pool, R.

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AB - Microbicides are a class of substances under development that could reduce the sexual transmission of HIV and other sexually transmitted diseases when applied locally to genital mucosal surfaces. Microbicide acceptability research has largely focused on product characteristics, rather than processes of negotiation within relationships about use. Gender relations, decision-making power and communication within sexual relationships are recognised as important determinants of condom and contraceptive use, and are likely to determine microbicide use also. As part of social science research linked to the Microbicides Development Programme (MDP) we combine relationship-based theories with anthropological work conducted with women and men using a placebo gel. We explore communication and decision-making in gel and condom use, including constructions of risk and trust. During the MDP301 Phase III pilot study, in-depth interviews were conducted at sites in South Africa, Tanzania, Uganda and Zambia. Following four weeks of placebo gel use, women and their partners were asked about gel use and acceptability, partner involvement, sexual practices and condom use. Data from 45 couples at five sites were analysed using a grounded theory approach in NVivo. Participation in the study did not require women to inform their partners, yet our data shows women seeking permission from their partners, negotiating disclosure, exchanging information and persuading or motivating for gel use. Although gel was supposedly 'woman-controlled', men exercised considerable influence in determining whether and how it was used. Despite this, negotiations around use were largely successful, since the gel increased sexual pleasure and provided opportunities for intimate communication and the building of trust. Decisions about condom and microbicide use are made in a dyadic context and involve a complex negotiation of risk and trust. Whilst preferences relating to product characteristics are largely individual, use itself is dependent on partnership dynamics and the broader social context in which sexual risk management occurs.

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KW - HIV

KW - WOMEN

KW - COMMUNICATION

KW - POWER

KW - CONSTRUCTION

KW - ADOLESCENTS

KW - STRATEGIES

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The role of partnership dynamics in determining the acceptability of condoms and microbicides

Abstract

Keywords

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