Body knowledge and mechanism of action: Microbicide use among clinical trial participants
Woodsong, C., Masoo, W., & Alleman, P. (2006, April). Body knowledge and mechanism of action: Microbicide use among clinical trial participants. Presented at Microbicides 2006, Cape Town, South Africa.
It is critical to understand the range of factors that influence microbicide acceptability and use. Information collected during a clinical trial can provide much-needed information for the conduct of clinical research as well as for future messages to encourage microbicide use, when efficacy has been established. A number of social science studies are currently under way in microbicide clinical trial settings, to explore a wide range of important issues that are expected to influence use.One fundamental, yet often overlooked area of interest is women’s knowledge about the body. Microbicide users’ understanding of the female reproductive system colors their perspectives on the microbicide delivery mode and mechanism of action, and this understanding will influence acceptability and use. Such body concepts vary widely between and within different cultural settings.This paper presents data from a study of microbicide acceptability conducted among women enrolled in a Phase II/IIb microbicide clinical trial in Malawi and Zimbabwe. A series of qualitative key informant interviews were conducted with trial participants. Included in these interviews was an investigation of trial participants’ knowledge of the female reproductive system, their concerns about trial products and their conceptualizations of how microbicides may work to prevent HIV infection. Participants’ concerns include misunderstandings about the vaginal-uterine vault, beliefs that applicators or condoms may get lost in the body, and fears that microbicides may “travel” to the stomach and cause pain. A number of participants also believed that the study gels can cure sexually transmitted infections.Results demonstrate (1) the importance of considering women’s body knowledge when conducting microbicide trials to improve adherence to trial protocol, and (2) the need to develop messages for microbicide users that incorporate aspects of alternative concepts about the body. Although clinical trials present an opportunity to provide women with this basic information, simple means of explaining relevant body functions and mechanisms of microbicide action will be needed for future microbicide users who are not enrolled in clinical trials.