Willingness to use microbicides among females who use unregulated drugs in Vancouver, Canada

Microbicides are an emerging HIV-focused biomedical intervention offering protection against HIV. Despite potential benefits, willingness to use these products has not been well studied, especially among females who use unregulated drugs. Between June 2021 and May 2022, data were drawn from two prospective cohorts of people who use drugs in Vancouver, Canada. Analyses focused on participants who were female sex at birth and sexually active. Multivariable logistic regression identified correlates of willingness to use a vaginal ring with microbicides. Awareness of microbicides was also assessed. Among 216 participants (median age 36; 47.2% Black, Indigenous, or a Person of Colour), only 32 (14.8%) reported prior awareness of microbicides. Once described, 57 (26.4%) expressed willingness to use a vaginal ring. Independent correlates of willingness included recent access to prescribed alternatives to unregulated drugs (AOR = 3.30, 95% CI = 1.19-9.15), willingness to take pre-exposure prophylaxis (PrEP) (AOR = 14.87, 95% CI = 6.38-34.65), and recent sex work engagement (AOR = 2.92, 95% CI = 1.19-7.15). Findings indicate low awareness and willingness to use microbicides among females who use drugs in Vancouver, Canada. While microbicides appear to offer important opportunities as a biomedical intervention, initial low levels of reported willingness indicate the impact may be limited.