Re-framing microbicide acceptability: findings from the MDP301 trial

Area of Science:

• Social and Behavioral Sciences
• Public Health
• HIV/AIDS Prevention Research

Background:

• Microbicide acceptability is typically defined by product characteristics and willingness to use within disease prevention frameworks.
• Existing conceptual models often overlook the emic ('insider') perspective and the integration of microbicides into daily life.
• Previous studies have made assumptions about microbicide use that empirical data has not adequately challenged.

Purpose of the Study:

• To explore women's lived experiences with microbicide gel within a large-scale clinical trial.
• To challenge common assumptions about microbicide acceptability by incorporating an emic perspective.
• To develop a richer, ethnographic understanding of microbicide acceptability.

Main Methods:

• Conducted in-depth interviews with female participants in the MDP301 Phase III microbicide trial.
• Included participants from South Africa, Zambia, Tanzania, and Uganda.
• Integrated social science methods within a clinical trial setting.

Main Results:

• Women's experiences with microbicide gel revealed meanings not captured by current definitions of acceptability.
• Current conceptual frameworks inadequately account for the diverse interpretations and uses of microbicides.
• An ethnographic and cross-cultural understanding of acceptability is achievable even within a clinical trial context.

Conclusions:

• Existing definitions of microbicide acceptability are insufficient.
• A holistic approach is needed to understand microbicide acceptability within the broader context of sexual health.
• Future research should prioritize emic interpretations and integrate microbicides into the complex realities of users' lives.