Exploring young women’s perceptions of the vaginal microbicide ring for preventing HIV in Johannesburg
Introduction: Young women are disproportionately affected by HIV. A combination of factors such as power imbalances in sexual relationships with men and obstacles adhering to HIV prevention products, increase their risk of HIV infection. There is a global commitment to develop and test female-controlled methods, with a focus on young women in low-middle income countries. Some efficacy trials demonstrated that younger women who used the vaginal microbicide ring received the least protection from HIV. This study explores how the social lives of young women influence their potential to use of the product. Methods: The study used a narrative approach to explore young women’s experiences using prevention products and their perceptions of the vaginal ring. Respondents were recruited from two communities in Soweto, Johannesburg using purposive and snowball sampling techniques. In-depth interviews and a focus group discussion were conducted to gather data that were analysed using the thematic content analysis method. Results: Lacking privacy as well as experiencing conflict and abuse in small, overcrowded homes affected young women’s psychological well-being and drove their preference for discreet prevention methods. They feared that using the vaginal ring without their partners knowing could raise issues of mistrust and compromise relationships. Women who asserted themselves in relationships and withstood men’s tendencies to control them, showed an ability to use the vaginal ring. Open and constructive communication about sexual health with sexual partners, family members and friends facilitated women’s positive experiences using prevention. Most respondents visited clinics regularly to use family planning and HIV testing services despite nurses ill-treating them. Conclusion: The nexus between young women’s complex lives and their ability to use the vaginal microbicide ring challenges the notion of it being a truly femalecontrolled device. Policies and initiatives to rollout the vaginal ring must take into v account the profound effect that dynamics in young women’s relationships and home lives have on uninterrupted use of the vaginal ring.
A research project submitted in partial fulfilment of the requirement for the Degree of Master of Public Health, in the field of Social and Behaviour Change Communication to the School of Public Health, University of the Witwatersrand, Johannesburg, 2020