Cultural differences in acceptability of a vaginal microbicide: a comparison between potential users from Nashville, Tennessee, USA, and Kafue and Mumbwa, Zambia

Figures & data

Table 1 Conditional acceptability of microbicide

Condition	Total n = 265		Nashville n = 164		Zambia n = 101		Chi-square*
	n	%	n	%	n	%	Value	P-value
If microbicide were a vaginal suppository	151	75.5	97	78.2	54	71.1	1.31	0.2523
If microbicide were a cream	158	77.8	91	72.2	67	87.0	6.06	0.0138
A small amount leaks out of your vagina after sex	99	52.1	69	57.0	30	43.5	3.23	0.0722
If the microbicide made your vagina wetter than you normally are during sex	124	62.6	102	83.6	22	28.9	59.77	<0.0001
If the microbicide made you drier than you normally are during sex	65	33.3	27	21.8	38	54.3	56.84	<0.0001
If the microbicide has a pleasant taste	146	80.2	92	80.7	54	79.4	0.04	0.8326
If the microbicide needs to be inserted at least 15 minutes before having sex	113	58.5	76	61.8	37	52.9	1.47	0.2259
If the microbicide is placed in the vagina with an applicator	156	80.0	101	90.6	55	58.3	25.69	<0.0001
If the microbicide is placed in the vagina with the fingers	133	70.4	86	69.9	47	71.2	0.03	0.8527

Notes: Number is the frequency and proportion of participants who indicated that the specific condition was probably and definitely acceptable.

* Chi-square test for the difference between Nashville and Zambia.

Table 3 Results of GLM separated by sites to determine association between conditional acceptability and perceived risk for acquiring STIs

	Nashville				Zambia
	Conditional acceptability		ANOVA		Conditional acceptability		ANOVA
	Mean	SD	F	P-value	Mean	SD	F	P-value
Regular consultations “checks” and wellness exams with a health care provider is the best way for me to avoid a sexually transmitted disease
Disagree	2.8	0.6	0.08	0.7810	2.3	0.9	3.9	0.0515
Agree	2.8	0.6			2.7	0.8
No matter what I do I am likely to get a sexually transmitted infection
Disagree	2.8	0.6	0.74	0.3902	2.5	0.9	0.9	0.3497
Agree	3.0	0.8			2.7	0.9
My partner has a lot to do with my getting or avoiding a sexually transmitted disease
Disagree	2.8	0.6	0.00	0.9477	2.3	0.9	2.8	0.1012
Agree	2.8	0.6			2.7	0.8
Luck plays a big part in determining if I can keep from getting a sexually transmitted infection
Disagree	2.8	0.6	5.59	0.0197	2.6	0.7	0.0	0.9276
Agree	3.4	0.6			2.6	0.9
If I take the right actions, I can avoid getting a sexually transmitted infection
Disagree	2.9	0.2	0.04	0.8355	2.5	1.0	0.3	0.5812
Agree	2.8	0.6			2.7	0.8
I refuse to have sex if my partner refuses to use a condom or latex barrier
Disagree	2.8	0.5	0.02	0.8889	2.3	0.8	10.0	0.0023
Agree	2.8	0.6			2.9	0.8
I feel almost certain that I will get AIDS
Disagree	2.8	0.6	4.04	0.0467	2.3	0.8	4.5	0.0363
Agree	2.3	0.7			2.7	0.9
My past behavior puts me at high risk for getting HIV or AIDS
Disagree	2.7	0.6	1.49	0.2243	2.4	0.7	16.6	0.0001
Agree	2.9	0.5			3.1	0.8

Abbreviations: STIs, sexually transmitted infections; GLM, generalized linear model.

Table 2 Characteristics of women enrolled in each study site (n = 265)

Characteristics	Nashville (n = 164)		Zambia (n = 101)		Chi-square
	n	%	n	%	Value	P-value
Marital status
Not married/live alone	73	60.3	24	24.0	29.3446	<0.0001
Married/live with partner	48	39.7	76	76.0
Years of education
Low education (1–12 years)	6	5.3	93	93.9	178.6293	<0.0001
High education (13+ years)	108	94.7	2	2.1
Paid work
Unemployed/non-paid work	28	23.0	76	79.2	68.0561	<0.0001
Employed/paid work	94	77.1	20	20.8
Mean age (SD)	36.4	12.6	31.1	10.4		0.0015
Any medical insurance
No	10	9.1	96	96.0	158.2717	<0.0001
Yes	100	90.9	4	4.0
See medical professionals regularly
No	15	12.2	78	78.0	98.2426	<0.0001
Yes	108	87.8	22	22.0
More than 12 months since last period
No	86	74.1	95	94.1	15.4846	<0.0001
Yes	30	25.9	6	5.9
Menopausal therapy (if reply to previous question about last period is “yes”)
No	119	97.5	90	96.8	0.1144	0.7352
Yes	3	2.5	3	3.2

Figure 1 Proportion of top 12 reasons to like a vaginal microbicide cited by women enrolled in the study.

Notes: “Effective at preventing pregnancy,” and “Not need a doctor to get it” were not cited as reasons by the Zambian cohort.