Giving voice to the end-user: input on multipurpose prevention technologies from the perspectives of young women in Kenya and South Africa.
Alexandra M MinnisEmily A KrogstadMary Kate Shapley-QuinnKawango AgotKhatija AhmedL Danielle WagnerAriane van der Stratennull nullPublished in: Sexual and reproductive health matters (2021)
ABSTRACTUnintended pregnancy and unmet need for modern contraception contribute substantially to reproductive health disparities globally. In sub-Saharan Africa they occur in contexts of disproportionately high rates of HIV infection. Multipurpose prevention technologies (MPTs) can address HIV and pregnancy prevention needs in a single "2-in-1" product; however, few studies have solicited end-user views to inform design of new MPTs. We conducted the Tablets, Ring, Injections as Options (TRIO) study with young women aged 18-30 in Kenya and South Africa (N = 277) to examine preferences and acceptability of future MPTs. In a randomised clinical cross-over study in which women used three placebo delivery forms, we complemented quantitative acceptability assessments with in-depth interviews and focus group discussions (N = 88 participants). We examined anticipated enablers and barriers to adoption and use of future MPTs and synthesised novel product design recommendations. Participants expressed high interest in MPTs. Anticipated side effects constituted a primary concern; however, many expected barriers were not dosage form-specific, but addressed contextual factors instead, such as fears regarding use of new biomedical technologies, misunderstandings and stigma regarding use, and navigating partner disclosure and engagement. Women preferred MPTs that offered discreetness and long-duration protection to minimise user-burden, did not interfere with their relationships, and conferred protection for unanticipated situations. End-user research to identify and pre-emptively address potential barriers while underscoring benefits to a new MPT product is vital. Attention to cultural contexts in implementation of new MPTs is important to communicating perceived benefits, achieving acceptability and maximising public health benefits.
Keyphrases
- south africa
- public health
- hiv positive
- pregnancy outcomes
- antiretroviral therapy
- clinical trial
- mental health
- social support
- primary care
- preterm birth
- human immunodeficiency virus
- hiv infected
- physical activity
- depressive symptoms
- risk assessment
- type diabetes
- hepatitis c virus
- double blind
- randomized controlled trial
- placebo controlled
- high resolution
- pregnant women
- electronic health record
- men who have sex with men
- human health
- adipose tissue
- mental illness
- metabolic syndrome
- social media
- climate change
- optical coherence tomography
- global health