Assuntos
Docentes de Medicina , Tutoria/organização & administração , Mentores , Centros Médicos Acadêmicos , Mobilidade Ocupacional , Eficiência Organizacional , Feminino , Humanos , Masculino , Ohio , Editoração/estatística & dados numéricos , Apoio à Pesquisa como Assunto/estatística & dados numéricosRESUMO
Young women are an important target group in microbicide research, yet little is known about why they participate and stay in microbicide trials. Our study examined motivations for participating in a Phase I microbicide trial among 61 women ages 18 - 24 years in the continental USA and Puerto Rico. We also examined their perspectives on study participation. Participants underwent a semi-structured in-depth interview in which they were asked about factors that motivated enrollment and their experiences while participating. They also completed a Web-based Computer Assisted Self Interview in which they were asked to rate study burden (1 = low to 4 = high). Factors that motivated enrollment were altruism (29%), compensation (17%), a combination of altruism and compensation (37%) and free medical exams (17%). Factors that encouraged participants to stay in the study were study staff (95%), confirmation of good health (41%), and the opportunity to learn about their bodies (17%). Mean ratings of study burden ranged from 1.83 (having to travel to site) to 2.41 (colposcopy), indicating that participants were not highly bothered by visits or procedures. Although Phase I trials require invasive procedures, participants were not highly bothered by them and recognized them as necessary. Good relationships with staff and clear information about how procedures contribute to study goals may encourage participants to remain in trials. Young women may be motivated to enter microbicide trials by stressing the role they will play in discovering better HIV-prevention methods and highlighting the comprehensive preventive exams they will receive.
RESUMO
This study assessed acceptability of the candidate microbicide VivaGel(®) and two placebo gels among 61 sexually active young US and Puerto Rican women at three sites. Participants were randomly assigned to use one of the gels twice per day for 14 days. At trial completion, 59% of the women in the VivaGel(®) group reported being likely to use the gel in the future, whereas 23% were unlikely to use it and 18% were undecided. Participants reported problems with all three gels, including the "universal" placebo containing hydroxyethyl cellulose (HEC). The most frequent complaints were leakage, interference with sexual behavior, and decreased sexual satisfaction. Some of the complaints are not new but remain unresolved. Women's perceived risk of HIV infection may determine whether the gels are used. Users also may want a choice of viscosity. Poor acceptability of vaginal microbicide formulations may result in poor adherence to gel use during efficacy trials and compromise validity of results.
Assuntos
Anti-Infecciosos Locais/administração & dosagem , Dendrímeros/administração & dosagem , Géis/administração & dosagem , Infecções por HIV/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Polilisina/administração & dosagem , Administração Intravaginal , Adolescente , Comportamento do Consumidor , Feminino , Infecções por HIV/etnologia , Humanos , Entrevistas como Assunto , Modelos Logísticos , Placebos/administração & dosagem , Porto Rico , Pesquisa Qualitativa , Comportamento Sexual , Fatores Socioeconômicos , Inquéritos e Questionários , Estados Unidos , Adulto JovemRESUMO
In a multi-site study of vaginal microbicide acceptability conducted with sexually active young women, quantitative assessments revealed significant differences in acceptability by site. Participants in Puerto Rico rated the gel more favourably than mainland US participants in terms of liking the gel and likelihood of future use. To explain these differences, we examined responses to qualitative behavioural assessments. Young women in mainland USA associated gel leakage with uncomfortable sensations experienced during menstruation, while young women in Puerto Rico had positive associations of gel use with douching. These negative or positive associations affected assessments of the gel's physical qualities. In addition, young women's perceptions of primary partners' support for microbicide use influenced sexual satisfaction with the gel and, ultimately, product acceptability. Finally, geographic HIV-risk context contributed to heightened HIV-risk perception, which influenced likelihood of future microbicide use, even for women in stated monogamous relationships. Future microbicide acceptability studies should take into account potential differences in acceptability by site such as HIV-risk perception based on local HIV prevalence, popularity of vaginal hygiene products in a specific area and male attitudes in different cultures concerning women's use of HIV protection strategies.
Assuntos
Anti-Infecciosos Locais/administração & dosagem , Infecções por HIV/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Infecções Sexualmente Transmissíveis/prevenção & controle , Cremes, Espumas e Géis Vaginais/administração & dosagem , Características Culturais , Feminino , Humanos , Entrevistas como Assunto , Porto Rico , Estados Unidos , Adulto JovemRESUMO
We sought to determine whether the interval between menarche and age of first sexual intercourse is associated with subsequent human papilloma virus (HPV) infection and if so, whether the association is independent of the age of first sexual intercourse. Female university students completed a survey and were screened for cervicovaginal HPV infection. HPV-positive subjects were matched to HPV-negative subjects (n = 504). Mean subject age was 20.4 +/- 2.1 years, age of first sexual intercourse 16.7 +/- 1.8 years, and interval 4.4 +/- 2.0 years. The interval was associated with HPV infection, but the association became nonsignificant in univariate stratified analyses and multivariate models estimating the association between the interval and HPV infection. A short interval is associated with HPV infection, but the association is not independent of age of first sexual intercourse. Age of first sexual intercourse should be considered an important and identifiable risk factor for subsequent HPV infection in research and clinical settings.