Article Text
Abstract
Background Multiple studies have shown that changes in the vaginal microbiome associated with increased risk of bacterial vaginosis (BV) are a risk for HIV acquisition and transmission. Therefore, hormonal interventions that prevent unintended pregnancies and promote vaginal health could reduce this risk. However, there is little data on acceptability of intravaginal rings in sub-Saharan Africa countries. We assessed the acceptance of a contraceptive vaginal ring (CVR) among women with BV and their male partners in Thika, Kenya.
Methods Between April 2016 to November 2017, we enrolled and treated women with BV aged 18–40 years. One month later, they were randomized to cyclical or continuous CVR and followed up monthly for 7 months. Additionally, we interviewed a sample of their male partners on their perspectives of the CVR. We conducted Fisher’s exact tests for each category of baseline demographics by whether or not women accepted to be randomized to CVR use and used descriptive statistics to summarize the views of their male partners.
Results A total 149 women were enrolled and 122 (81.9%) initiated CVR at the randomization visit. Reasons for not initiating CVR were, 17 (11.4%) did not return for randomization and were considered lost to follow-up, 6 (4%) expressly refused to use CVR, and 4 (2.7%) terminated due to other reasons. There were no differences between randomized and non-randomized women except by pre-specified categories of number of children (p=0.02). Of the 32 male partners that were interviewed, 96.9% were fine with their partners using the CVR, 78.1% reported that the ring was a very effective contraceptive method while 3.1% reported that it caused physical discomfort during sex.
Conclusion There was high acceptability of CVR among women with BV and their male partners in Kenya. Therefore, vaginal rings are a promising strategy that should be evaluated for delivery of multipurpose prevention in Kenyan women.
Disclosure No significant relationships.