Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
RESEARCH ARTICLE

Attitudes of men in an Australian male tolerance study towards microbicide use

Wendy R. Holmes A D , Lisa Maher B and Susan L. Rosenthal C
+ Author Affiliations
- Author Affiliations

A Centre for International Health, Macfarlane Burnet Institute for Medical Research and Public Health, 23–87 Commercial Road, Melbourne, Vic. 3004, Australia.

B National Centre in HIV Epidemiology and Clinical Research, St Vincent’s Medical Centre, Level 2, 376 Victoria Street, Darlinghurst, NSW 2010, Australia.

C Department of Pediatrics and Sealy Center for Vaccine Development, University of Texas Medical Branch, Galveston, TX 77555-0351, USA.

D Corresponding author. Email: holmes@burnet.edu.au

Sexual Health 5(3) 273-278 https://doi.org/10.1071/SH07093
Submitted: 17 November 2007  Accepted: 15 May 2008   Published: 6 August 2008

Abstract

Background: Vaginal microbicides are in development to provide new options for the prevention of sexually transmissible infections. Although promoted as a female-initiated product, men may influence the decision to use a microbicide and the way that it is used, so it is important to explore their views. Methods: Men (n = 36) enrolled in a 7-day, phase 1 clinical safety trial of SPL7013 Gel were interviewed pre- and post-use of the gel. The trial did not include use of the gel during sex. Interviews were digitally-recorded and transcribed verbatim, and analysed using a framework approach. Results: The men (mean age 37 years) were interested in the idea of vaginal microbicides, had little knowledge about them, and varied beliefs about how they work. They tended to assess microbicide use in relation to condoms and lubricants. Many would want a microbicide to be as effective as condoms. Participants did not anticipate difficulties discussing use with their partners. Many thought that a microbicide would be less intrusive than condoms; some anticipated that the lubricating properties might enhance sexual pleasure. Some anticipated using a microbicide with a condom or with a lubricant, and a few raised questions about the timing of use and use during different types of sexual activity. Conclusions: No major barriers to microbicide use were found in this sample of Australian men, who anticipated being willing to use them if they are shown to be safe and effective. Our findings should help to inform the design of further studies as well as future information materials and anticipatory guidance.

Additional keywords: acceptability, sexuality.


Acknowledgements

The study was funded with US Federal funds from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, under Contract No. HHSN266200500042C to Starpharma Pty Ltd. Susan Rosenthal is supported by a grant from the National Institute of Child Health and Human Development of the National Institutes of Health (R01 HD40151–01). Lisa Maher is supported by a National Health and Medical Research Council Career (NHMRC) Development Award. The National Centre in HIV Epidemiology and Clinical Research is core-funded by the Australian Government Department of Health and Ageing. The authors would like to acknowledge Marcus Chen, Principal Investigator of the male tolerance study; Laura Clark, Mary Poynten, and Iona Millwood for contribution to the design and coordination of the clinical trial; David Wain and Kirk Peterson for conducting interviews and liaising with participants; Julie Silvers, Fiona MacFarlane, and other clinic staff at the Melbourne Sexual Health Centre for oversight of the study, recruitment and management of participants, and for management of data and records; Melissa Loza and Megan Elbon for help with data organisation, and most importantly, the participants for giving their time and sharing their experiences.


References


[1] Holmes KK,  Levine R,  Weaver M. Effectiveness of condoms in preventing sexually transmitted infections. Bull World Health Organ 2004; 82 454–64.
PubMed | [verified 1 August 2007].

[8] Smith AMA,  Jolley D,  Hocking J,  Benton K,  Gerofi J. Factors affecting men’s liking of condoms they have used. Int J STD AIDS 1999; 10 258–62.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[9] Lim MS,  Hellard ME,  Aitken CK,  Hocking JS. Sexual-risk behaviour, self-perceived risk and knowledge of sexually transmissible infections among young Australians attending a music festival. Sex Health 2007; 4 51–6.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[10] Mantell JE,  Dworkin SL,  Exner TM,  Hoffman S,  Smit JA,  Susser I. The promises and limitations of female-initiated methods of HIV/STI protection. Soc Sci Med 2006; 63 1998–2009.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[11] Bentley ME,  Fullem AM,  Tolley EE,  Kelly CW,  Jogelkar N,  Srirak N, et al. Acceptability of a microbicides among women and their partners in a 4-country phase I trial. Am J Public Health 2004; 94 1159–64.
PubMed |

[12] Bentley ME,  Morrow KM,  Fullem A,  Chesney MA,  Horton SD,  Rosenberg Z, et al. Acceptability of a novel vaginal microbicide during a safety trial among low-risk women. Fam Plann Perspect 2000; 32 184–8.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[13] Morrow K,  Rosen R,  Richter L,  Emans A,  Forbes A,  Day J, et al. The acceptability of an investigational vaginal microbicide, PRO 2000 gel, among women in a phase I clinical trial. J Women’s Health 2003; 12 655–66.
Crossref | GoogleScholarGoogle Scholar |

[14] Coggins C,  Blanchard K,  Friedland B. Men’s attitudes towards a potential vaginal microbicide in Zimbabwe, Mexico and the USA. Reprod Health Matters 2000; 8 132–41.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[15] Carballo-Diéguez A,  Balán IC,  Morrow K,  Rosen R,  Mantell JE,  Gai F, et al. Acceptability of tenofovir gel as a vaginal microbicide by US male participants in a Phase I clinical trial (HPTN 050). AIDS Care 2007; 19 1026–31.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[16] Farr G,  Gabelnick H,  Sturgen K,  Dorflinger L. Contraceptive efficacy and acceptability of the female condom. Am J Public Health 1994; 84 1960–4.
CAS | PubMed |

[17] Widman L,  Welsh DP,  McNulty JK,  Little KC. Sexual communication and contraceptive use in adolescent dating couples. J Adolesc Health 2006; 39 893–9.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[18] Frank ML,  Poindexter AN,  Cox CA,  Bateman L. A cross-sectional survey of condom use in conjunction with other contraceptive methods. Women Health 1995; 23 31–46.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[19] Severy LJ,  Tolley E,  Woodsong C,  Guest G. A framework for examining the sustained acceptability of microbicides. AIDS Behav 2005; 9 121–31.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[20] Ritchie J , Spencer L . Qualitative data analysis for applied policy research. In: Bryman A, Burgess RG (eds). Analyzing qualitative data. New York: Routledge; 1994. pp. 173–194.

[21] Baleta A. A second chance for microbicides. Lancet 2007; 370 17–8.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[22] Foss AM,  Vickerman PT,  Heise L,  Watts CH. Shifts in condom use following microbicide introduction: should we be concerned? AIDS 2003; 17 1227–37.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[23] Imrie J,  Elford J,  Kippax S,  Hart G. Biomedical HIV prevention – and social science. Lancet 2007; 370 10–1.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[24] Cassell M,  Halperin DT,  Shelton JD,  Stanton D. Risk compensation: the Achilles’ heel of innovation in HIV prevention. BMJ 2006; 332 605–7.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[25] Smith AMA,  Jolley D,  Hocking J,  Benton K,  Gero J. Does additional lubrication affect condom slippage and breakage? Int J STD AIDS 1998; 9 330–5.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[26] Balzarini J,  Van Damme L. Microbicide drug candidates to prevent HIV infection. Lancet 2007; 369 787–97.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[27] Keogh LA. Understandings of the ‘natural’ body: a comparison of the views of users and providers of emergency contraception. Sex Health 2005; 2 109–15.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[28] Braunstein S,  van de Wijgert J. Preferences and practices related to vaginal lubrication: implications for microbicide acceptability and clinical testing. J Women’s Health 2005; 14 424–33.
Crossref | GoogleScholarGoogle Scholar |

[29] Messiah A,  Blin P,  Fiche V. Sexual repertoires of heterosexuals: implications for HIV/sexually transmitted disease risk and prevention. The ACSF Group. AIDS 1995; 9 1357–65.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[30] de Visser RO,  Smith AM,  Rissel CE,  Richters J,  Grulich AE. Sex in Australia: heterosexual experience and recent heterosexual encounters among a representative sample of adults. Aust N Z J Public Health 2003; 27 146–54.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[31] Mosher WD , Chandra A , Jones J . Sexual behavior and selected health measures: men and women 15–44 years of age, United States, 2002. CDC Advance data from health and vital statistics. 2005; 362. Available online at: http://www.cdc.gov/nchs/data/ad/ad362.pdf. [verified 26 July 2007].

[32] Halperin DT. Heterosexual anal intercourse: prevalence, cultural factors, and HIV infection and other health risks. Part I. AIDS Patient Care STDS. 1999; 13 717–30.
CAS | PubMed |

[33] Richters J,  Grulich AE,  de Visser RO,  Smith AM,  Rissel CE. Sex in Australia: autoerotic, esoteric and other sexual practices engaged in by a representative sample of adults. Aust N Z J Public Health 2003; 27 180–90.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[34] Leone P,  Warren T,  Hamed K,  Fife K,  Wald A. Famciclovir reduces viral mucosal shedding in HSV-seropositive persons. Sex Transm Dis 2007; 34 900–7.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[35] Tolley EE,  Severy LJ. Integrating behavioral and social science research into microbicide clinical trials: challenges and opportunities. Am J Public Health 2006; 96 79–83.
Crossref | GoogleScholarGoogle Scholar | PubMed |