Carraguard acceptability among men and women in a couples study in Thailand

The aim of this study is to evaluate the use and acceptability of Carraguard among men and women enrolled as couples in a microbicide trial.

Focus groups were conducted with participants in a 6-month randomized, placebo-controlled trial that enrolled sexually active, low-risk couples in Thailand. Participants were blinded as to which gel they had received at the time of the discussions.

Most men and women liked the gel and found it acceptable. The majority of men and women thought that using the gel increased sexual pleasure, although participants disagreed about whether using the gel increased sexual frequency. Drawbacks of gel use included that it was too wet or messy, and nearly all respondents thought that the applicator was too hard. Most men and women questioned the utility of using the gel among married couples since gel use was tied to perception of HIV/STI risk. However, those who perceived themselves to be at risk expressed interest in using the product as an alternative to condoms. Many women were particularly interested in a product that also had contraceptive properties. Gel use also raised issues of trust and fidelity among couples and questions about men's ability to detect women's use of the product.

Men and women in this study found the gel acceptable and thought that it should be made available if it is found to be safe and effective. Strategies for marketing a potential microbicide product must take the target population into consideration. For married couples, key considerations may be partner dynamics and trust issues, whereas messages focusing on sexual pleasure or disease prevention may resonate more strongly with sex workers or other populations.