Drug-involved women as potential users of vaginal microbicides for HIV and STD prevention: a three-city survey

We wished to obtain potential users' perspectives on vaginal microbicides from a population of women at high risk for HIV. We conducted a face-to-face survey of convenience samples (total n = 743) of drug-using women and female sexual partners of male injection drug users in Bridgeport, Connecticut, Providence, Rhode Island, and San Juan, Puerto Rico. Ninety percent of respondents said that they would be very likely to use microbicides with paying partners and 78% with primary partners (p = 0.001). High hypothetical likelihood of use was expressed even after several potential product characteristics (e.g., causes minor vaginal irritation or burning) were rated as unacceptable. Latinas had significantly higher predicted likelihood of use with primary (p = 0. 001) and paying partners (p = 0.018) than blacks and whites. Eighty percent of respondents preferred products that enhance sexual pleasure by providing additional lubrication or "wetness." More than 80% of respondents said that they would want their primary partners to know of their microbicide use, and 42% (p = 0.001) said that they would want their paying partners to know. Women's concern about a paying partner's violent response to suggested use of risk reduction measures was inversely related to predicted likelihood of microbicide use (p = 0.045). Microbicides should be assessed in the context of the potential users' actual relationships and cultures. Achieving broad acceptability among drug-involved women will require a range of products.