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Acceptability of oral and topical HIV chemoprophylaxis in India: implications for at-risk women and men who have sex with men

Nomita Chandhiok A D , Smita N. Joshi B and Raman Gangakhedkar C
+ Author Affiliations
- Author Affiliations

A Indian Council of Medical Research, Ansari Nagar, New Delhi 110029, India.

B Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital Premises, 32 Sassoon Road, Pune 411001, India.

C National AIDS Research Institute, Bhosari, Pune 411026, India.

D Corresponding author. Email: n_chandhiok@hotmail.com

Sexual Health 11(2) 171-179 https://doi.org/10.1071/SH13067
Submitted: 1 May 2013  Accepted: 28 July 2013   Published: 11 October 2013

Abstract

With reducing HIV prevalence, India has made gains in containing the epidemic. Yet, unprotected sex and commercial sex work, unprotected anal sex between men and needle sharing among intravenous drug users continue to drive the epidemic. Development of effective, safe and acceptable topical (microbicides) and oral (pre-exposure prophylaxis (PrEP)) chemoprophylaxis could augment the already available tools for HIV prevention. This paper reviews the acceptability of topical microbicides and oral PrEP, in the context of the nature of the HIV epidemic, the sociocultural norms and the acceptability data obtained from studies carried out in India. Overall, men and women have a positive attitude towards the concept and use of microbicide products. Self-perceptions of HIV risk, product attributes, ease and convenience of use during sex, gender norms, the sociocultural context and the potential for undisclosed use were important factors influencing acceptability. A multipurpose product that would simultaneously address women’s contraceptive and disease prevention needs would be devoid of the stigma attached to an anti-HIV product and may be more acceptable. Limited information on the acceptability of oral PrEP amongst high-risk groups merits further research, including carrying out demonstration projects for program introduction.

Additional keywords: microbicides, pre-exposure prophylaxis, sex workers.


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