- Over 80% of women reported liking each of the three microbicide delivery methods tested (vaginal film, soft-gel capsule, and tablet). Over 85% said they would use the product.
- The film and soft-gel capsule were preferred by 39% and 37% of women respectively, while the tablet was preferred by 25%. Ease of use and faster dissolving time were cited as reasons for preferences.
- Product preference varied by country, with the soft-gel capsule preferred in Burkina Faso and Tanzania (42-46%) and the film preferred in Zambia (51%). Age, socioeconomic status, and marital status did not significantly impact preferences.
This study assessed the acceptability of tenofovir gel as a potential vaginal microbicide among women participating in a phase I clinical trial through a mixed-methods approach. Quantitative data indicated that 94% of participants stated they would probably or definitely use the gel. However, qualitative group discussions revealed a more complex picture of acceptability, with women raising concerns about lubrication, leakage, effects on sexual pleasure, and the possibility of covert use. The authors conclude that while participants were generally accepting of the gel based on quantitative responses, qualitative findings show acceptability is shaped by multiple contextual factors important for product development and optimization of use. Future microbicide trials should include strategic mixed-methods acceptability assessments.
This study assessed the acceptability of tenofovir gel as a potential vaginal microbicide among women participants in a phase I clinical trial through a mixed-methods approach. Quantitative data found that 94% of participants stated they would probably or definitely use the gel. However, qualitative group discussions revealed a more complex picture of acceptability, with women expressing a range of views on factors like lubrication, leakage, and effects on sexual pleasure. The authors conclude that while most women found the gel acceptable according to the quantitative data, qualitative research provided important contextual factors around acceptability that manufacturers should consider to optimize future microbicide products. Using mixed methods to collect both types of acceptability data in clinical trials was deemed useful.
This study evaluated the knowledge, attitudes and practices of 30 traditional birth attendants in Cameroon regarding danger signs in pregnancy and infection prevention. The average age of attendants was 49.6 years. Most had no formal education beyond primary school. While all attendants reported referring women in difficult deliveries, only 40% did so regularly. Common reasons for referral included convulsions, heavy bleeding, and large stomach size. Over 70% reported regularly washing hands, but few used other infection prevention measures consistently. The study found traditional birth attendants play an important role but could benefit from additional training to improve safety.
This study examined vaginal practices and willingness to use vaginal microbicides among 23 black women in New York City. The researchers found:
1) Willingness to use a vaginal product for HIV prevention was high, especially among more educated women, though safety concerns were prominent.
2) Most women reported using douching in their lifetime for cleanliness, with vinegar and water being common ingredients.
3) Choices around vaginal practices and products were influenced by assessments of risks and efficacy, experiences, culture, and general approach to healthcare including use of complementary and alternative medicine.
4) While preferences varied, attitudes toward a vaginal microbicide were likely to be positive if side effects
The document summarizes a study examining vaginal practices and willingness to use vaginal microbicides among 23 black women in New York City. Key findings include:
1) Willingness to use vaginal products for HIV prevention was high, especially among more educated women, though safety concerns were prominent.
2) Most women reported using douching in their lifetime for cleanliness, with vinegar and water being common ingredients.
3) Choices around vaginal practices and products were influenced by assessments of risks and efficacy, experiences, culture, and general healthcare approach including use of complementary and alternative medicine.
4) While preferences varied, attitudes toward a vaginal product were likely to be positive if side effects
Alternative medicines in women with chronic vaginitis april 2011Tito Chavez
Users of complementary and alternative medicines for chronic vaginitis were more likely to be younger, report greater stress and more disruptive symptoms, and have seen multiple doctors compared to non-users. The most common alternative therapies included yogurt and acidophilus supplements. While alternative medicine users were more likely to report previous diagnoses of yeast infections or bacterial vaginosis, current diagnoses did not differ between the groups.
This document summarizes a study on the acceptability of tenofovir gel as a potential vaginal microbicide for preventing HIV transmission.
1) Quantitative data found that 94% of women said they would probably or definitely use the gel, indicating high acceptability. However, qualitative discussions revealed a more complex picture, with women having varying opinions on factors like lubrication and leakage.
2) While most women liked the gel's color, smell, and consistency, qualitative findings showed opinions varied on issues like the thickness and application process requiring privacy.
3) The study demonstrated the value of mixed quantitative and qualitative methods to provide a fuller understanding of microbicide acceptability, as qualitative data provided important contextual factors and
Factors Influencing Occurrence of Diabetes Mellitus in Shieywe Location Kakam...paperpublications3
This study examined factors influencing the occurrence of diabetes mellitus in Shieywe location, Kakamega County, Kenya. 327 respondents participated in the study, of which 135 (41.3%) were female and 192 (58.7%) were male. Most respondents had only a primary education. The study found that most respondents attributed diabetes to physical labor like lifting heavy loads. Few respondents engaged in exercise like walking or bicycling. Many diabetics had to travel over 6 km or 2-5 km to reach health facilities for treatment and management of their condition. The study concluded that health services for diabetes need to be more accessible by being available at local health centers to improve management of the disease.
This study assessed the acceptability of tenofovir gel as a potential vaginal microbicide among women participating in a phase I clinical trial through a mixed-methods approach. Quantitative data indicated that 94% of participants stated they would probably or definitely use the gel. However, qualitative group discussions revealed a more complex picture of acceptability, with women raising concerns about lubrication, leakage, effects on sexual pleasure, and the possibility of covert use. The authors conclude that while participants were generally accepting of the gel based on quantitative responses, qualitative findings show acceptability is shaped by multiple contextual factors important for product development and optimization of use. Future microbicide trials should include strategic mixed-methods acceptability assessments.
This study assessed the acceptability of tenofovir gel as a potential vaginal microbicide among women participants in a phase I clinical trial through a mixed-methods approach. Quantitative data found that 94% of participants stated they would probably or definitely use the gel. However, qualitative group discussions revealed a more complex picture of acceptability, with women expressing a range of views on factors like lubrication, leakage, and effects on sexual pleasure. The authors conclude that while most women found the gel acceptable according to the quantitative data, qualitative research provided important contextual factors around acceptability that manufacturers should consider to optimize future microbicide products. Using mixed methods to collect both types of acceptability data in clinical trials was deemed useful.
This study evaluated the knowledge, attitudes and practices of 30 traditional birth attendants in Cameroon regarding danger signs in pregnancy and infection prevention. The average age of attendants was 49.6 years. Most had no formal education beyond primary school. While all attendants reported referring women in difficult deliveries, only 40% did so regularly. Common reasons for referral included convulsions, heavy bleeding, and large stomach size. Over 70% reported regularly washing hands, but few used other infection prevention measures consistently. The study found traditional birth attendants play an important role but could benefit from additional training to improve safety.
This study examined vaginal practices and willingness to use vaginal microbicides among 23 black women in New York City. The researchers found:
1) Willingness to use a vaginal product for HIV prevention was high, especially among more educated women, though safety concerns were prominent.
2) Most women reported using douching in their lifetime for cleanliness, with vinegar and water being common ingredients.
3) Choices around vaginal practices and products were influenced by assessments of risks and efficacy, experiences, culture, and general approach to healthcare including use of complementary and alternative medicine.
4) While preferences varied, attitudes toward a vaginal microbicide were likely to be positive if side effects
The document summarizes a study examining vaginal practices and willingness to use vaginal microbicides among 23 black women in New York City. Key findings include:
1) Willingness to use vaginal products for HIV prevention was high, especially among more educated women, though safety concerns were prominent.
2) Most women reported using douching in their lifetime for cleanliness, with vinegar and water being common ingredients.
3) Choices around vaginal practices and products were influenced by assessments of risks and efficacy, experiences, culture, and general healthcare approach including use of complementary and alternative medicine.
4) While preferences varied, attitudes toward a vaginal product were likely to be positive if side effects
Alternative medicines in women with chronic vaginitis april 2011Tito Chavez
Users of complementary and alternative medicines for chronic vaginitis were more likely to be younger, report greater stress and more disruptive symptoms, and have seen multiple doctors compared to non-users. The most common alternative therapies included yogurt and acidophilus supplements. While alternative medicine users were more likely to report previous diagnoses of yeast infections or bacterial vaginosis, current diagnoses did not differ between the groups.
This document summarizes a study on the acceptability of tenofovir gel as a potential vaginal microbicide for preventing HIV transmission.
1) Quantitative data found that 94% of women said they would probably or definitely use the gel, indicating high acceptability. However, qualitative discussions revealed a more complex picture, with women having varying opinions on factors like lubrication and leakage.
2) While most women liked the gel's color, smell, and consistency, qualitative findings showed opinions varied on issues like the thickness and application process requiring privacy.
3) The study demonstrated the value of mixed quantitative and qualitative methods to provide a fuller understanding of microbicide acceptability, as qualitative data provided important contextual factors and
Factors Influencing Occurrence of Diabetes Mellitus in Shieywe Location Kakam...paperpublications3
This study examined factors influencing the occurrence of diabetes mellitus in Shieywe location, Kakamega County, Kenya. 327 respondents participated in the study, of which 135 (41.3%) were female and 192 (58.7%) were male. Most respondents had only a primary education. The study found that most respondents attributed diabetes to physical labor like lifting heavy loads. Few respondents engaged in exercise like walking or bicycling. Many diabetics had to travel over 6 km or 2-5 km to reach health facilities for treatment and management of their condition. The study concluded that health services for diabetes need to be more accessible by being available at local health centers to improve management of the disease.
Branch vital, angela condom use among african-american women-nfmij-6-1-09William Kritsonis
Dr. William Allan Kritsonis, Editor-in-Chief, NATIONAL FORUM JOURNALS (Founded 1982). Dr. Kritsonis has served as an elementary school teacher, elementary and middle school principal, superintendent of schools, director of student teaching and field experiences, professor, author, consultant, and journal editor. Dr. Kritsonis has considerable experience in chairing PhD dissertations and master thesis and has supervised practicums for teacher candidates, curriculum supervisors, central office personnel, principals, and superintendents. He also has experience in teaching in doctoral and masters programs in elementary and secondary education as well as educational leadership and supervision. He has earned the rank as professor at three universities in two states, including successful post-tenure reviews.
This document summarizes a study that assessed the prevalence of asymptomatic genital tract infections (GTIs) among sexually active youth in South Africa. The study found:
1) Over two-thirds of young women tested positive for at least one GTI, compared to just 10% of young men, with the majority of infections being asymptomatic.
2) Syndromic management identified a small fraction of actual GTI cases and was suboptimal for screening this population.
3) Youths' high burden of asymptomatic GTIs and other vulnerabilities increase their risk for HIV, highlighting the need for improved laboratory-based GTI screening and youth-centered HIV prevention programs.
An Assessment of Birth Control Measures Among Women in Reproductive Age of Ka...ijtsrd
This study aimed to assess the impact of age on attitudes of married women regarding family planning and birth control measures in Kashmir. A sample of 400 married women aged 18-50 years was selected through random sampling. Data was collected using a family planning attitude scale and questionnaire. The results showed that the majority of women across all age groups had a medium level of concern about adoption of family planning measures. A medium level of concern was also observed regarding population problems, family planning, birth control, fertility control, abortion as a birth control method, and contraceptive methods. The level of concern was generally consistent across the different age groups.
— Female genital tuberculosis is one of the major etiological factors of female infertility. Diagnosis of genital tuberculosis is very important in such cases. So this comparative observational type of study was carried out on infertile women to compare the diagnostic effectively of ultrasonograpgy (USG), genital tuberculosis, Tuberculin test, Nucleic acid amplification test (PCR), histopathology and hysteroscopy & laparoscopy (DHL) assuming culture as gold standard. It was observed that the 28% of infertile cases were found positive for genital tuberculosis on culture. Sensitivity of PCR 64.28%, DHL 92.85%, USG 42.85%, Histopathology 60.71% and Tuberculin Test 64.28%. So sensitivity was found with significant variation ranging from 42.85% with ultrasonography (USG) to 92.85% with DHL. Specificity of PCR 52.77%, DHL 55.55%, USG 98.61%, Histopathology 91.66% and Tuberculin Test 36.11%. So specificity was also found with significant variation being found maximum with USG (98.61%) and minimum with tuberculin test (36.11%). Positive predictive value (PPV) was found maximum (92.3%) with USG and minimum (28.12%) with tuberculin test and negative predictive value (NPV) was found maximum (95.23%) with DHL and minimum (72.22%) with tuberculin test. Diagnostic effectively of diagnosing GTB with various studied modalities vary with significant variation.
This study evaluated the pharmacokinetics of dapivirine, an antiretroviral drug, in lactating women using a dapivirine vaginal ring for 14 days. The study found:
1) Dapivirine was present at low concentrations in breast milk and plasma compared to cervicovaginal fluid.
2) The median estimated daily infant exposure to dapivirine through breast milk was 74.3 ng/kg/day (less than 1 microgram per day).
3) Use of the dapivirine vaginal ring was well-tolerated with few adverse events reported, none requiring ring removal.
McMillan Worth The impact ofsocio-cultural context on young people's condom useKaren McMillan
This article discusses factors that influence young people's condom use in Tonga and Vanuatu based on interviews with 62 people aged 18-25. It finds a disconnect between positive attitudes towards condoms and low actual usage. Social and cultural influences play a strong role in condom decisions by shaping identity, norms, and traditions. Effective HIV prevention requires understanding these contextual factors rather than just focusing on individual knowledge and attitudes. Country-specific approaches are also needed given cultural differences between Pacific nations.
This study analyzed Caesarian section rates in women with gestational diabetes (GDM) using the Robson classification system, which sorts women into 10 groups based on obstetric factors. The study found that:
1) Women with GDM had over 1.5 times the risk of needing a C-section compared to the general obstetric population, with a C-section rate of 32.5% for GDM patients vs 19.6% overall.
2) Nulliparous women with GDM who were induced (Robson group 2a) had a C-section rate of 63.3%, over twice as high as the rate for similar women without GDM.
3
Dr. William Allan Kritsonis, Editor-in-Chief, NATIONAL FORUM JOURNALS (Founded 1982). Dr. Kritsonis has served as an elementary school teacher, elementary and middle school principal, superintendent of schools, director of student teaching and field experiences, professor, author, consultant, and journal editor. Dr. Kritsonis has considerable experience in chairing PhD dissertations and master thesis and has supervised practicums for teacher candidates, curriculum supervisors, central office personnel, principals, and superintendents. He also has experience in teaching in doctoral and masters programs in elementary and secondary education as well as educational leadership and supervision. He has earned the rank as professor at three universities in two states, including successful post-tenure reviews.
This study analyzed social inequalities and inequalities in access to and utilization of prenatal and delivery health care services according to skin color using data from 9,633 postpartum women in Rio de Janeiro, Brazil from 1999-2001. The results showed two main findings:
1) Black and mulatto women consistently faced more adverse social conditions and had less access to care compared to white women, including higher rates of adolescent pregnancy, less education and paid employment, and less utilization of prenatal services.
2) These inequalities persisted even when stratified by education level, indicating discrimination occurred based on both education and skin color in the delivery of health services.
The diagnostic outcome for women presenting with postcoital bleeding - Dr Aym...AymanEwies
1. This study evaluated 284 women presenting with postcoital bleeding (PCB) to assess diagnostic findings and compare outcomes between those over 35 and under 35.
2. The incidence of cervical intraepithelial neoplasia was 9% for women with normal smears and PCB, and 66.1% for women referred due to abnormal smears and PCB.
3. Cervical cancer was found in 3.6% of women with normal smears and PCB, and 5% of women with abnormal smears and PCB, indicating prompt referral is needed for PCB.
The CLARITY Challenge aimed to develop standards for clinical genome sequencing by having groups analyze whole exome and genome sequencing data from three families with genetic disorders. 30 international groups participated. Their analyses showed convergence in bioinformatics techniques but diversity in medical interpretation and reporting, demonstrating these areas require further standardization. Only two groups identified the consensus candidate variants in all cases, showing methods need fine-tuning. The Challenge assessed current practices and their ability to diagnose genetic diseases from sequencing data.
An assessment of adolescent eating habits in public schools of chak shahzad, ...Zubia Qureshi
Abstract: Eating patterns influence the nutritional status, health, learning process and academic performance of the school children. This study was conducted to explore the food availability at school canteens and food intake by adolescents in break period. A cross sectional study was conducted on 290 adolescents (145 were girls and 145 boys) of 6th, 7th and 8th grade from public schools of Chak Shahzad, Islamabad. Pre-structured questionnaire was used for data collection. Chi square / fisher exact test was done by using SPSS to check the association. The mean age of adolescents was 12.6 ± 1.33 years. They were reported normal, underweight, overweight and obese as 176 (60.7%), 79 (27.2%), 27 (9.3%) and 9 (2.8%) respectively. Nutritional status was significantly related with gender, age and grade of adolescents with p-value <0.05. Response showed that 199 (68.6%) adolescents prefer canteen food during break time, and 66 (22.8%) give preference to homemade lunch. Few of them 25 (8.6%) take fruits in school break time. About (24.8%) took drink with lunch which were juices 30 (10.3%), milk/milk shake 14 (5.9%), carbonated drinks 6 (2.1%), and tea/coffee 13 (4.5%). Consumption of carbohydrates, protein, fruits, vegetables, and dairy products was found as 64 (22.1%), 26 (0.9%), 32 (11%), 4 (1.4%) and 1 (0.3%) respectively in adolescents who brought their lunch from home. Around 49% of students were not satisfied with food provided on their school canteens. Availability of food items on school canteens and overall eating pattern of adolescents is not satisfactory. There is a need of school canteen guidelines/policy and nutritional education to canteen staff and pupils.
Keywords: School Canteen, Pakistan, Eating Habits, Adolescents
HIV prevalence and incidence remain high in peri-urban areas of KwaZulu-Natal, South Africa according to a study of three districts. Cross-sectional surveys found HIV prevalence of 42% in Ladysmith, 46% in Edendale, and 41% in Pinetown. Follow-up cohort studies in these areas then determined HIV incidence rates of 14.8, 6.3, and 7.2 per 100 person-years, respectively. Pregnancy incidence was also high at 5.7, 3.1, and 6.3 per 100 person-years despite high reported contraceptive use. These findings suggest ongoing high risk of HIV transmission in these communities.
HIV prevalence and incidence remain high in peri-urban areas of KwaZulu-Natal, South Africa according to a study of three districts. Cross-sectional surveys found HIV prevalence of 42% in Ladysmith, 46% in Edendale, and 41% in Pinetown. Follow-up cohort studies in these areas measured HIV incidence rates of 14.8, 6.3, and 7.2 per 100 person-years respectively. Pregnancy incidence was also high at 5.7, 3.1, and 6.3 per 100 person-years despite high reported contraceptive use. These findings suggest ongoing high risk of HIV transmission in these communities.
This study used mixed quantitative and qualitative methods to assess the acceptability of tenofovir gel, an experimental vaginal microbicide, among women participating in an early phase clinical trial. While 94% of women stated they would likely use the gel based on quantitative surveys, qualitative group discussions revealed a more complex picture of acceptability, with factors like lubrication, leakage during sex, impact on pleasure, and potential for covert use emerging as important. The authors conclude that future microbicide trials should include strategic mixed-methods data collection to better understand acceptability from multiple perspectives.
This study used mixed quantitative and qualitative methods to assess the acceptability of tenofovir gel, an experimental vaginal microbicide, among women participating in an early phase clinical trial. While 94% of women stated they would likely use the gel based on quantitative surveys, qualitative group discussions revealed a more complex picture of acceptability, with concerns around lubrication, leakage during sex, impact on pleasure, and potential for covert use. The authors conclude that future microbicide trials should include strategic mixed-methods data collection to better understand acceptability from multiple perspectives.
This study assessed family planning practices among the urban slum population in Lucknow, India. Over 500 recently delivered women were surveyed using cluster sampling. The results found that over 60% had knowledge of contraceptive methods, with over half currently using contraception. The most common methods were condoms, birth control pills, IUDs, and sterilization. Around 30% cited religious reasons for not using contraception, while others reported lack of knowledge, husband's reluctance, or financial constraints. The study recommends popularizing newer family planning practices, educating men on vasectomy, and providing more community awareness programs on reproductive health for slum residents.
This study examined vaginal practices and willingness to use vaginal microbicides among 23 black women in New York City. The researchers found:
1) Willingness to use a vaginal product for HIV prevention was high, especially among more educated women, though safety concerns were prominent.
2) Most women reported using douching in their lifetime for cleanliness, with vinegar and water being common ingredients.
3) Choices around vaginal practices and products were influenced by assessments of risks and efficacy, experiences, culture, and general approach to healthcare including use of complementary and alternative medicine.
4) While preferences varied, attitudes toward a vaginal microbicide were likely to be positive if side effects
This study assessed the acceptability of tenofovir gel as a potential vaginal microbicide among women participants in a phase I clinical trial through a mixed-methods approach. Quantitative data found that 94% of participants stated they would probably or definitely use the gel. However, qualitative group discussions revealed a more complex picture of acceptability, with women expressing a range of views on factors like lubrication, leakage, and effects on sexual pleasure. The authors conclude that while most women found the gel acceptable according to the quantitative data, qualitative research provided important contextual factors around acceptability that manufacturers should consider to optimize future microbicide products. Using mixed methods to collect both types of acceptability data in clinical trials was deemed useful by the
This study used mixed-methods to assess acceptability of tenofovir gel as a potential vaginal microbicide for HIV prevention. Quantitative data from interviews found 94% of participants stated they would likely use the gel. However, qualitative group discussions revealed a more complex picture, with women expressing a range of opinions about factors like lubrication, leakage during sex, and effects on sexual pleasure. The authors conclude that while participants were generally open to using the gel, acceptability is shaped by individual contexts and experiences. They argue future microbicide trials should include strategic mixed-methods data collection to better understand acceptability.
This study examined antenatal care (ANC) utilization patterns among women in South Egypt. The study found that most women in both urban and rural areas had regular ANC visits and started early in the first trimester. However, utilization of primary health care facilities for ANC was limited compared to private clinics. Women's knowledge about the contents of ANC visits was poor. The study concluded that more efforts are needed to promote primary health care's role in ANC and increase women's awareness about ANC services.
Branch vital, angela condom use among african-american women-nfmij-6-1-09William Kritsonis
Dr. William Allan Kritsonis, Editor-in-Chief, NATIONAL FORUM JOURNALS (Founded 1982). Dr. Kritsonis has served as an elementary school teacher, elementary and middle school principal, superintendent of schools, director of student teaching and field experiences, professor, author, consultant, and journal editor. Dr. Kritsonis has considerable experience in chairing PhD dissertations and master thesis and has supervised practicums for teacher candidates, curriculum supervisors, central office personnel, principals, and superintendents. He also has experience in teaching in doctoral and masters programs in elementary and secondary education as well as educational leadership and supervision. He has earned the rank as professor at three universities in two states, including successful post-tenure reviews.
This document summarizes a study that assessed the prevalence of asymptomatic genital tract infections (GTIs) among sexually active youth in South Africa. The study found:
1) Over two-thirds of young women tested positive for at least one GTI, compared to just 10% of young men, with the majority of infections being asymptomatic.
2) Syndromic management identified a small fraction of actual GTI cases and was suboptimal for screening this population.
3) Youths' high burden of asymptomatic GTIs and other vulnerabilities increase their risk for HIV, highlighting the need for improved laboratory-based GTI screening and youth-centered HIV prevention programs.
An Assessment of Birth Control Measures Among Women in Reproductive Age of Ka...ijtsrd
This study aimed to assess the impact of age on attitudes of married women regarding family planning and birth control measures in Kashmir. A sample of 400 married women aged 18-50 years was selected through random sampling. Data was collected using a family planning attitude scale and questionnaire. The results showed that the majority of women across all age groups had a medium level of concern about adoption of family planning measures. A medium level of concern was also observed regarding population problems, family planning, birth control, fertility control, abortion as a birth control method, and contraceptive methods. The level of concern was generally consistent across the different age groups.
— Female genital tuberculosis is one of the major etiological factors of female infertility. Diagnosis of genital tuberculosis is very important in such cases. So this comparative observational type of study was carried out on infertile women to compare the diagnostic effectively of ultrasonograpgy (USG), genital tuberculosis, Tuberculin test, Nucleic acid amplification test (PCR), histopathology and hysteroscopy & laparoscopy (DHL) assuming culture as gold standard. It was observed that the 28% of infertile cases were found positive for genital tuberculosis on culture. Sensitivity of PCR 64.28%, DHL 92.85%, USG 42.85%, Histopathology 60.71% and Tuberculin Test 64.28%. So sensitivity was found with significant variation ranging from 42.85% with ultrasonography (USG) to 92.85% with DHL. Specificity of PCR 52.77%, DHL 55.55%, USG 98.61%, Histopathology 91.66% and Tuberculin Test 36.11%. So specificity was also found with significant variation being found maximum with USG (98.61%) and minimum with tuberculin test (36.11%). Positive predictive value (PPV) was found maximum (92.3%) with USG and minimum (28.12%) with tuberculin test and negative predictive value (NPV) was found maximum (95.23%) with DHL and minimum (72.22%) with tuberculin test. Diagnostic effectively of diagnosing GTB with various studied modalities vary with significant variation.
This study evaluated the pharmacokinetics of dapivirine, an antiretroviral drug, in lactating women using a dapivirine vaginal ring for 14 days. The study found:
1) Dapivirine was present at low concentrations in breast milk and plasma compared to cervicovaginal fluid.
2) The median estimated daily infant exposure to dapivirine through breast milk was 74.3 ng/kg/day (less than 1 microgram per day).
3) Use of the dapivirine vaginal ring was well-tolerated with few adverse events reported, none requiring ring removal.
McMillan Worth The impact ofsocio-cultural context on young people's condom useKaren McMillan
This article discusses factors that influence young people's condom use in Tonga and Vanuatu based on interviews with 62 people aged 18-25. It finds a disconnect between positive attitudes towards condoms and low actual usage. Social and cultural influences play a strong role in condom decisions by shaping identity, norms, and traditions. Effective HIV prevention requires understanding these contextual factors rather than just focusing on individual knowledge and attitudes. Country-specific approaches are also needed given cultural differences between Pacific nations.
This study analyzed Caesarian section rates in women with gestational diabetes (GDM) using the Robson classification system, which sorts women into 10 groups based on obstetric factors. The study found that:
1) Women with GDM had over 1.5 times the risk of needing a C-section compared to the general obstetric population, with a C-section rate of 32.5% for GDM patients vs 19.6% overall.
2) Nulliparous women with GDM who were induced (Robson group 2a) had a C-section rate of 63.3%, over twice as high as the rate for similar women without GDM.
3
Dr. William Allan Kritsonis, Editor-in-Chief, NATIONAL FORUM JOURNALS (Founded 1982). Dr. Kritsonis has served as an elementary school teacher, elementary and middle school principal, superintendent of schools, director of student teaching and field experiences, professor, author, consultant, and journal editor. Dr. Kritsonis has considerable experience in chairing PhD dissertations and master thesis and has supervised practicums for teacher candidates, curriculum supervisors, central office personnel, principals, and superintendents. He also has experience in teaching in doctoral and masters programs in elementary and secondary education as well as educational leadership and supervision. He has earned the rank as professor at three universities in two states, including successful post-tenure reviews.
This study analyzed social inequalities and inequalities in access to and utilization of prenatal and delivery health care services according to skin color using data from 9,633 postpartum women in Rio de Janeiro, Brazil from 1999-2001. The results showed two main findings:
1) Black and mulatto women consistently faced more adverse social conditions and had less access to care compared to white women, including higher rates of adolescent pregnancy, less education and paid employment, and less utilization of prenatal services.
2) These inequalities persisted even when stratified by education level, indicating discrimination occurred based on both education and skin color in the delivery of health services.
The diagnostic outcome for women presenting with postcoital bleeding - Dr Aym...AymanEwies
1. This study evaluated 284 women presenting with postcoital bleeding (PCB) to assess diagnostic findings and compare outcomes between those over 35 and under 35.
2. The incidence of cervical intraepithelial neoplasia was 9% for women with normal smears and PCB, and 66.1% for women referred due to abnormal smears and PCB.
3. Cervical cancer was found in 3.6% of women with normal smears and PCB, and 5% of women with abnormal smears and PCB, indicating prompt referral is needed for PCB.
The CLARITY Challenge aimed to develop standards for clinical genome sequencing by having groups analyze whole exome and genome sequencing data from three families with genetic disorders. 30 international groups participated. Their analyses showed convergence in bioinformatics techniques but diversity in medical interpretation and reporting, demonstrating these areas require further standardization. Only two groups identified the consensus candidate variants in all cases, showing methods need fine-tuning. The Challenge assessed current practices and their ability to diagnose genetic diseases from sequencing data.
An assessment of adolescent eating habits in public schools of chak shahzad, ...Zubia Qureshi
Abstract: Eating patterns influence the nutritional status, health, learning process and academic performance of the school children. This study was conducted to explore the food availability at school canteens and food intake by adolescents in break period. A cross sectional study was conducted on 290 adolescents (145 were girls and 145 boys) of 6th, 7th and 8th grade from public schools of Chak Shahzad, Islamabad. Pre-structured questionnaire was used for data collection. Chi square / fisher exact test was done by using SPSS to check the association. The mean age of adolescents was 12.6 ± 1.33 years. They were reported normal, underweight, overweight and obese as 176 (60.7%), 79 (27.2%), 27 (9.3%) and 9 (2.8%) respectively. Nutritional status was significantly related with gender, age and grade of adolescents with p-value <0.05. Response showed that 199 (68.6%) adolescents prefer canteen food during break time, and 66 (22.8%) give preference to homemade lunch. Few of them 25 (8.6%) take fruits in school break time. About (24.8%) took drink with lunch which were juices 30 (10.3%), milk/milk shake 14 (5.9%), carbonated drinks 6 (2.1%), and tea/coffee 13 (4.5%). Consumption of carbohydrates, protein, fruits, vegetables, and dairy products was found as 64 (22.1%), 26 (0.9%), 32 (11%), 4 (1.4%) and 1 (0.3%) respectively in adolescents who brought their lunch from home. Around 49% of students were not satisfied with food provided on their school canteens. Availability of food items on school canteens and overall eating pattern of adolescents is not satisfactory. There is a need of school canteen guidelines/policy and nutritional education to canteen staff and pupils.
Keywords: School Canteen, Pakistan, Eating Habits, Adolescents
HIV prevalence and incidence remain high in peri-urban areas of KwaZulu-Natal, South Africa according to a study of three districts. Cross-sectional surveys found HIV prevalence of 42% in Ladysmith, 46% in Edendale, and 41% in Pinetown. Follow-up cohort studies in these areas then determined HIV incidence rates of 14.8, 6.3, and 7.2 per 100 person-years, respectively. Pregnancy incidence was also high at 5.7, 3.1, and 6.3 per 100 person-years despite high reported contraceptive use. These findings suggest ongoing high risk of HIV transmission in these communities.
HIV prevalence and incidence remain high in peri-urban areas of KwaZulu-Natal, South Africa according to a study of three districts. Cross-sectional surveys found HIV prevalence of 42% in Ladysmith, 46% in Edendale, and 41% in Pinetown. Follow-up cohort studies in these areas measured HIV incidence rates of 14.8, 6.3, and 7.2 per 100 person-years respectively. Pregnancy incidence was also high at 5.7, 3.1, and 6.3 per 100 person-years despite high reported contraceptive use. These findings suggest ongoing high risk of HIV transmission in these communities.
This study used mixed quantitative and qualitative methods to assess the acceptability of tenofovir gel, an experimental vaginal microbicide, among women participating in an early phase clinical trial. While 94% of women stated they would likely use the gel based on quantitative surveys, qualitative group discussions revealed a more complex picture of acceptability, with factors like lubrication, leakage during sex, impact on pleasure, and potential for covert use emerging as important. The authors conclude that future microbicide trials should include strategic mixed-methods data collection to better understand acceptability from multiple perspectives.
This study used mixed quantitative and qualitative methods to assess the acceptability of tenofovir gel, an experimental vaginal microbicide, among women participating in an early phase clinical trial. While 94% of women stated they would likely use the gel based on quantitative surveys, qualitative group discussions revealed a more complex picture of acceptability, with concerns around lubrication, leakage during sex, impact on pleasure, and potential for covert use. The authors conclude that future microbicide trials should include strategic mixed-methods data collection to better understand acceptability from multiple perspectives.
This study assessed family planning practices among the urban slum population in Lucknow, India. Over 500 recently delivered women were surveyed using cluster sampling. The results found that over 60% had knowledge of contraceptive methods, with over half currently using contraception. The most common methods were condoms, birth control pills, IUDs, and sterilization. Around 30% cited religious reasons for not using contraception, while others reported lack of knowledge, husband's reluctance, or financial constraints. The study recommends popularizing newer family planning practices, educating men on vasectomy, and providing more community awareness programs on reproductive health for slum residents.
This study examined vaginal practices and willingness to use vaginal microbicides among 23 black women in New York City. The researchers found:
1) Willingness to use a vaginal product for HIV prevention was high, especially among more educated women, though safety concerns were prominent.
2) Most women reported using douching in their lifetime for cleanliness, with vinegar and water being common ingredients.
3) Choices around vaginal practices and products were influenced by assessments of risks and efficacy, experiences, culture, and general approach to healthcare including use of complementary and alternative medicine.
4) While preferences varied, attitudes toward a vaginal microbicide were likely to be positive if side effects
This study assessed the acceptability of tenofovir gel as a potential vaginal microbicide among women participants in a phase I clinical trial through a mixed-methods approach. Quantitative data found that 94% of participants stated they would probably or definitely use the gel. However, qualitative group discussions revealed a more complex picture of acceptability, with women expressing a range of views on factors like lubrication, leakage, and effects on sexual pleasure. The authors conclude that while most women found the gel acceptable according to the quantitative data, qualitative research provided important contextual factors around acceptability that manufacturers should consider to optimize future microbicide products. Using mixed methods to collect both types of acceptability data in clinical trials was deemed useful by the
This study used mixed-methods to assess acceptability of tenofovir gel as a potential vaginal microbicide for HIV prevention. Quantitative data from interviews found 94% of participants stated they would likely use the gel. However, qualitative group discussions revealed a more complex picture, with women expressing a range of opinions about factors like lubrication, leakage during sex, and effects on sexual pleasure. The authors conclude that while participants were generally open to using the gel, acceptability is shaped by individual contexts and experiences. They argue future microbicide trials should include strategic mixed-methods data collection to better understand acceptability.
This study examined antenatal care (ANC) utilization patterns among women in South Egypt. The study found that most women in both urban and rural areas had regular ANC visits and started early in the first trimester. However, utilization of primary health care facilities for ANC was limited compared to private clinics. Women's knowledge about the contents of ANC visits was poor. The study concluded that more efforts are needed to promote primary health care's role in ANC and increase women's awareness about ANC services.
Management of Labor in Pregnant Women using Traditional Medicines in Northern...Premier Publishers
Labor comes with pain, hence expectant mothers would desire for procedures and materials that would quicken the process and provide relief to the extreme pain. Women in developing countries are known to patronize traditional medicines hence it is most probable traditional medicines will be used for labor purposes. This study therefore assessed the level of usage of traditional medicines among pregnant women in the Tamale metropolis, identified the products used and their reasons for usage. Using convenience sampling method, data was collected from 301 respondents from 20 suburbs within the Tamale metropolis using a semi-structured questionnaire. Data was analyzed using SPSS version 23 and association between variables obtained using appropriate tools. Up to 25.9% of respondents used traditional medicine immediately before or during their most recent labor. Lower educational status, staying with extended family members, being a believer in Islam, home delivery and ever using traditional medicine before the most recent pregnancy were statistically associated with the use of traditional medicine to manage labor processes (p < 0.05). Various plants were found in formulating the traditional labor medicine known locally as ‘kalghutim’ with the bark of the Shea tree ((Vitellaria paradoxa) being present in most formulations.
International Journal of Humanities and Social Science Invention (IJHSSI)inventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Contraceptive methods & factors associated with modern contraceptives useAnjum Hashmi MPH
The study examined contraceptive use among 288 females in Karachi, Pakistan. Modern contraceptive methods, such as injections, implants, and IUDs, were used by 75% of participants. Factors associated with higher odds of modern contraceptive use included: being younger than 30 years old, receiving information from a family planning worker, and having a child younger than 1 year old. Television and billboard advertisements were associated with lower odds of modern contraceptive use. The study provides insight into prevalent contraceptive methods and influencing factors in the region.
Misconceptions about Oral Contraceptive Pill Used Among Women at Primary Heal...iosrjce
This document summarizes a study that examined misconceptions about oral contraceptive pills among women in Holy Karbala City, Iraq. The study involved a survey of 200 women attending primary health care centers. The survey assessed demographic information, reproductive histories, and levels of agreement with statements about potential consequences of oral contraceptive use. The results found that most participants were between 21-35 years old, housewives, and had primary education or less. Regarding reproductive histories, most had 1-2 pregnancies and deliveries. Assessment of misconceptions showed that over 50% of participants believed myths such as oral contraceptives causing nervousness or infertility. However, participants correctly understood the effectiveness of oral contraceptives in preventing pregnancy
The study assessed knowledge, attitude, and practices regarding emergency contraception among 366 female students in Mekelle, Northern Ethiopia. The key findings were:
1) About 90.7% of respondents had heard of emergency contraception. Three-fourths (75.7%) had good knowledge and over half (64.9%) had a positive attitude.
2) Older age was significantly associated with greater awareness. Those over 18 were more likely to have good knowledge compared to younger students.
3) Age and ethnicity also influenced attitude - younger students and non-Tigre ethnic groups were less likely to have a positive attitude.
4) While knowledge and attitude were high, the study
Alternative medicines in women with chronic vaginitis april 2011Tito Chavez
This study examined the use of complementary and alternative medicines (CAMs) among 481 women with chronic vaginitis. The researchers found that 64.9% of women used some form of CAM therapy. The most common treatments were yogurt and acidophilus pills. Younger women, those experiencing greater stress and symptom interference, and those with a history of vaginal infections were more likely to use CAMs. While CAM use was common, a diagnosis of vulvovaginal candidiasis was not associated with greater CAM use.
This document summarizes a study that assessed knowledge of contraceptive methods and the impact of health education among married women in India. The study used a pre-test post-test design and surveyed 1200 married women between the ages of 18-45 before and after a health education intervention. The results showed that before the intervention, knowledge of female sterilization was highest at 93.6%, while knowledge of other methods like oral contraceptives and condoms was lower. After the health education, knowledge increased to nearly 100% for all discussed methods. The study concluded that health education significantly improved knowledge of contraceptive methods and that sociodemographic factors like education level were associated with existing knowledge.
Prevalence of Hpv Infection in the Lekoumou and Niari Departments (Congo Braz...JohnJulie1
This study aimed to determine the prevalence of HPV infection in women in the Lekoumou and Niari departments of Congo Brazzaville. The researchers collected samples from 100 women aged 16-73 and tested them for HPV. They found an overall HPV prevalence of 29%. Certain demographic factors like age, education level, marital status, age of first intercourse, number of sexual partners and parity did not show statistically significant associations with HPV infection status. The study provides baseline data on HPV prevalence in the region that can inform future cervical cancer prevention efforts.
Prevalence of Hpv Infection in the Lekoumou and Niari Departments (Congo Braz...NainaAnon
This study aimed to determine the prevalence of HPV infection in women in the Lekoumou and Niari departments of Congo Brazzaville. The researchers collected samples from 100 women aged 16-73 and tested them for HPV. They found an overall HPV prevalence of 29%, with the highest rates (58.3%) in women over 50. No significant associations were found between HPV infection and factors like education level, age of first intercourse, number of sexual partners, or number of pregnancies. The study provides baseline data on HPV prevalence in these regions of Congo to help guide cervical cancer prevention efforts.
Clinics of Oncology | Oncology Journals | Open Access JournaEditorSara
Clinics of OncologyTM (ISSN 2640-1037) - Impact Factor 1.920* is a medical specialty that focuses on the use of operative techniques to investigate and resolve certain medical conditions caused by disease or traumatic injury
This document provides an overview of various techniques used in biotechnology and molecular biology to study DNA, including X-ray crystallography, chromatography, electrophoresis, ultracentrifugation, UV spectroscopy, restriction enzymes, DNA cloning, sequencing, probes, Southern blotting, and polymerase chain reaction. These techniques have contributed to understanding the structure of DNA and sequencing the human genome, enabling research on genetic diseases.
Radiopharmacy involves the compounding and dispensing of radioactive materials for use in nuclear medicine procedures. Radiopharmaceuticals are radioactive drugs used for diagnostic or therapeutic purposes. They consist of radioactive isotopes attached to other molecules to allow for localization within the body. Radiopharmaceuticals are prepared following stringent quality control procedures to ensure safety, purity and sterility prior to administration. Effective shielding is also required to protect personnel from radiation exposure during preparation and handling.
The document provides an outline for lectures on pharmaceutical dosage form processing. It will cover general introduction to manufacturing processes, formulation assessment, analytical method development, formulation development, good manufacturing practices, and drug product stability. Key aspects of preformulation are also summarized, including characterizing organoleptic properties, purity, particle size and shape, solubilization using surfactants, and preformulation stability studies. Manufacturing processes involve transforming raw materials into finished products through various treatment, machining, and reshaping steps while ensuring quality.
Colloids have many important applications in pharmaceuticals, food, and industry. Pharmaceutical applications include using colloids for drug delivery and therapy, as well as coating tablets for protection and controlled release. Colloids are also important in food products like milk, butter, and ice cream. Industrial uses involve non-drip paints, sewage treatment, clarifying water, and in artificial kidney machines.
This document discusses polymers and their applications in drug delivery. It begins by defining polymers as large molecules composed of repeating monomer units. The document then covers different types of polymers based on their structure and properties, including thermoplastics, thermosets, and elastomers. It also addresses various polymerization methods and classifications. The document discusses mechanisms of drug release from polymers, including diffusion, degradation, and swelling. It provides examples of controlled drug delivery applications using polymers, such as transdermal patches, implants, and biodegradable systems. In closing, it emphasizes the benefits of biodegradable polymers for localized, sustained drug delivery with reduced side effects.
This document discusses different types and design considerations for sedimentation processes used in water and wastewater treatment to remove solids via gravity settling. It describes four types of settling (discrete, flocculent, zone, and compression) and compares design parameters for discrete and flocculent settling. The document outlines batch settling tests and analyses, including determining zone settling velocity and its relationship to solids concentration. It provides details on designing zone settling tanks, including mass balances and limiting flux analyses to size tanks and select operating parameters like underflow rate.
Lyophilization, also known as freeze drying, is a process used to remove water from materials while preserving their structure. It involves freezing the material and then reducing pressure to allow the frozen water to sublimate from the solid to gas phase. The process is carried out below the triple point of water to enable sublimation of ice. Freeze drying has applications in the food and pharmaceutical industries as it can preserve thermolabile compounds and materials by removing water while retaining quality.
This document provides an overview of heat transfer and related topics. It discusses the three methods of heat transfer: convection, conduction, and radiation. It also covers factors that affect heat transfer like temperature and thermal resistance. The document outlines course contents on heat transfer equipment, fired process equipment, and combustion of fuels. It provides details on topics like heat exchangers, boilers, burners, and methods of heat exchange.
Extraction theory involves removing soluble materials from insolids using liquid solvents. Liquid-liquid extraction is a useful method to separate components of a mixture based on differences in solubility between solvents. For example, sugar can be extracted from vegetable oil by shaking the mixture with water, as sugar is more soluble in water than oil. The partition coefficient K quantifies differences in solubility, with some compounds made more water-soluble by conversion to ionic salt forms using acid or base treatment. This allows separation of organic acid/base mixtures based on differing solubility properties.
This document discusses various processes by which water changes phase from liquid to gas, including evaporation, transpiration, and sublimation. It provides details on the factors that control evaporation rates, such as energy inputs, temperature, humidity, wind, and water availability. It explains the differences between potential evapotranspiration (PET) and actual evapotranspiration (AET). Transpiration from plants and how it is affected by various environmental factors is also covered. Common methods for measuring and estimating evaporation and evapotranspiration are presented.
Distillation is a process used to separate mixtures based on differences in their boiling points. It involves heating the mixture until it vaporizes, then cooling the vapors until they condense. There are several types of distillation processes. Simple distillation is used to purify liquids. Fractional distillation separates mixtures with components of different boiling points. Steam distillation is used for mixtures containing water. Vacuum distillation allows distillation of substances that decompose at their normal boiling points. Destructive distillation involves decomposition during heating.
This document provides an overview of crystallization as a separation and purification technique. It discusses key concepts such as crystallization, nucleation, crystal growth, and factors that affect crystallization. Specifically, it describes three steps of crystallization from solution: induction of supersaturation through methods like cooling, solvent evaporation, or adiabatic evaporation; nucleation through Miers' theory; and crystal growth which depends on concentration, temperature, and velocity gradients. It also discusses methods of controlling crystal size and factors that influence the crystallization process like temperature, impurities, and agitation.
This document discusses coagulation and flocculation processes. It defines key terms like coagulation and flocculation. It also poses questions to prompt a detailed explanation of the processes, examples of their applications, and potential topics for group discussion including further explaining the processes with examples and applications.
This document discusses the importance and process of mixing in pharmaceutical manufacturing. It makes several key points:
1) Mixing is required in most pharmaceutical products to ensure uniform distribution of active ingredients and proper functioning of the dosage form.
2) The type of mixing needed (positive, negative, neutral) depends on the product components and how they interact.
3) Achieving a perfectly mixed state is impossible, so the goal is a random mixture with minimal variation between doses.
4) Both the number of particles in a dose and the proportion of active ingredient impact mixing quality and uniformity. More of each improves consistency.
This document provides an overview of filtration theory and processes. It defines filtration as the removal of solids suspended in a liquid by passing the liquid through a porous medium that retains the solids. Various filter types and operating mechanisms are described, including depth filtration, cake filtration, and clarification. Key factors that affect filtration rates such as pressure, viscosity, permeability, and particle size are also discussed. Dimensionless parameters important to modeling filtration like the Reynolds number are introduced.
This document provides an overview of drying in the pharmaceutical industry. It discusses the importance of drying as the last stage of manufacturing before packaging. The key types of drying covered are convective, conductive, and radiative drying. Convective drying can be static bed or dynamic fluidized bed. Conductive drying uses vacuum ovens or tumblers. Radiative drying includes infrared and microwave radiation. Factors that influence drying like moisture content, bound vs unbound water, and equilibrium moisture content are also explained.
This document discusses size reduction and comminution. It outlines the objectives of size reduction such as improving flow properties and increasing surface area. It examines how material properties like brittleness, toughness, and hardness influence size reduction. Different size reduction methods are described, including cutting, compression, impact, attrition, and combined impact/attrition. Specific equipment like ball mills, hammer mills, and fluidized mills are discussed in terms of how they achieve size reduction through impacts and attrition. Factors that influence particle size distribution changes during milling are also covered.
Adsorption is the adhesion of atoms, ions or molecules from a gas, liquid or dissolved solid onto a surface. There are two types of adsorption - physical adsorption, which involves relatively weak van der Waals forces, and chemisorption, which involves stronger chemical bonding. Physical adsorption is rapid, reversible and allows for multilayers, while chemisorption is specific, may require activation energy, and allows only for monolayers. Factors like solute concentration, temperature, pH, and surface area affect adsorption from solutions. Pharmaceutical applications of adsorption include chromatography, removal of toxins, taste masking, and haemoperfusion. Adsorption can also cause issues like loss of pot
This document provides an overview of rheology concepts including:
1. It defines rheology as the science concerned with the deformation of matter under stress.
2. It describes Newtonian and non-Newtonian fluids, explaining that Newtonian fluids have a constant viscosity while non-Newtonian fluids have variable viscosity.
3. It discusses the different types of non-Newtonian flow - plastic, pseudoplastic, and dilatant - and provides examples of materials that exhibit each type of flow.
This document discusses polymers and their applications in drug delivery. It begins with an introduction to polymers, including their classification and molecular structure. It then covers general mechanisms of drug release from polymers, including diffusion, degradation and swelling. Applications of polymers in conventional dosage forms and controlled drug delivery are presented. The document also discusses biodegradable polymers and natural polymers. It provides details on the classification, characteristics and selection of polymers for drug delivery.
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Jwh.2010
1. Acceptability of Vaginal Film, Soft-Gel Capsule,
and Tablet as Potential Microbicide Delivery Methods
Among African Women
Annalene M. Nel, MBChB, Ph.D.,1
Lynne B. Mitchnick,2
Peter Risha, Ph.D.,3
Lungwani Tyson Makoye Muungo, Ph.D.,4
and Pamela M. Norick1
Abstract
Background: Vaginal microbicides are in development for the prevention of HIV transmission to women via
sexual intercourse. Acceptability of the microbicide delivery method in the targeted population is important to
product adherence and, therefore, product effectiveness. It is anticipated that multiple delivery methods will be
required to satisfy personal preferences among future microbicide users.
Methods: A total of 526 sexually active women aged 18–30 years participated in a consumer product preference
study in Burkina Faso, Tanzania, and Zambia. Screened women who had given consent were instructed to use
each of the three products (placebo formulations of a vaginal tablet, film, and soft-gel capsule) once daily for 7
consecutive days for a total of 21 days. Women were interviewed about their impressions of the product at the
completion of each 7-day trial period.
Results: Over 80% of women reported they liked using each dosage form, and over 85% said they would
definitely use it. The film and soft-gel capsule were chosen significantly more often than the tablet as the
preferred dosage form (39% and 37% vs. 25%, respectively) mainly because of faster dissolving time and easier
insertion. Women in Burkina Faso and Tanzania preferred the soft-gel capsule (42%–46%), whereas Zambian
women preferred the film (51%). Age, socioeconomic status, and marital status did not significantly affect
product preference.
Conclusions: All three dosage forms were acceptable to the women surveyed. Preferred dosage forms varied by
country. These data suggest that the availability of microbicides in multiple dosage forms may increase ac-
ceptability, adherence, and, therefore, effectiveness.
Introduction
HIV/AIDS is the leading cause of death globally in
women 15–44 years of age and the most important sin-
gle cause of disease burden for African women aged 15–59
years.1 Current HIV prevention options for women are lim-
ited, and new self-initiated prevention options are urgently
needed.
Vaginal microbicides are designed to reduce the transmis-
sion of HIV to women during sexual intercourse. Multiple
dosage forms, such as gels, rings, tablets, soft-gel capsules
(SGC), and films are in development. Factors such as fre-
quency of product use (with each sex act, daily, monthly),
adaptability of product to large-scale production, and
production costs vary with each dosage form.2
Acceptability
of the microbicide delivery method in the targeted population
is important to product adherence and, therefore, product
effectiveness. Based on experience with hormonal contra-
ceptives,3,4
it is anticipated that multiple dosage forms will be
required to satisfy personal preferences among future mi-
crobicide users. The acceptability of three vaginal dosage
forms, film, SGC, and tablet, was studied in sexually active,
adult women in Burkina Faso, Tanzania, and Zambia. The
results of previous acceptability studies with nonoxynol-9 (N-
9) vaginal film5–7
and the Praneem polyherbal vaginal tablet
(Panacea Biotech Ltd., New Delhi, India)8,9
have shown that
these dosage forms are acceptable to the majority of female
study participants and their male sexual partners.
1International Partnership for Microbicides, Silver Spring, Maryland.
2MR Solutions, Inc., North Bergen, New Jersey.
3School of Pharmacy, Muhimbili University of Health & Allied Sciences, Dar es Salaam, Tanzania.
4Department of Pharmacy, University of Zambia, Lusaka, Zambia.
JOURNAL OF WOMEN’S HEALTH
Volume 20, Number 8, 2011
ª Mary Ann Liebert, Inc.
DOI: 10.1089/jwh.2010.2476
1207
2. Materials and Methods
Study design
Sexually active women aged 18–30 participated in a con-
sumer product preference study in Burkina Faso, Tanzania,
and Zambia in 2009. By design, half of participants were 18–24
years of age and half were 25–30 years, half were married or
living with a partner and half were single (including divorced
or widowed), and half were of lower and half were of higher
socioeconomic status (SES). SES was determined based on
education, home ownership, job type, and ownership of
household property.
Women were recruited door-to-door at their residences.
The rationale for door-to-door recruitment was that it maxi-
mized convenience for the participants while simultaneously
helping to target SES. No one was present, with the exception
of small children when necessary, when the women were
recruited and interviewed. Interviews were conducted inside
or immediately outside of the woman’s house, according to
her preference. Screened women who gave consent who were
not pregnant were asked to use each of three products (pla-
cebo formulations of a vaginal film, SGC, and tablet) once
daily for 7 consecutive days for a total of 21 days. The order of
product usage was based on a complete randomized block
design.
Women received a 7-day supply (10 applications) of a
single dosage form at the time of enrollment. When they met
with study staff at the end of the product usage period, un-
used product was collected, a product evaluation survey was
administered, and a 7-day supply (10 applications) of the
second dosage form was provided. The procedure was re-
peated with the third dosage form. With the women’s per-
mission, male sexual partners who consented completed a
quantitative survey at the end of the study.
The ethics committees that reviewed and approved this
study were University of Zambia Biomedical Research
Ethics Committee (UNZAREC), Comite´ d’e´thique pour la
recherche en sante´ (National Ethics Committee Burkina
Faso), and National Institute for Medical Research (NIMR,
Tanzania).
Materials
The placebo film was manufactured by MonoSol (Merrill-
ville, IN) and consisted of (by weight) 25% glycerin, 25%
polyvinyl alcohol, 20% hydroxypropyl methylcellulose, 20%
polyethylene glycol, 5% propylene glycol, and 5% croscar-
mellose sodium. The translucent, off-white film measured
2.0 · 1.0cm and was supplied in individual sealed wrappers
(Fig. 1A). The placebo SGC was K-YÒ
LiquibeadsÔ (McNeil-
PPC, Fort Washington, PA) and consisted of dimethicone,
gelatin, glycerin, and dimethiconol. The clear, oval-shaped
SGC measured 2.5· 1.25 cm and was supplied in individual
blister packs (Fig. 1B). The product dissolves in the vagina
within 1–2 hours, and the dissolve rate varies from woman to
woman (McNeil-PPC, personal communication). The placebo
tablet was manufactured by Azopharma (Miramar, FL) and
consisted of (by weight) 47.7% lactose, 15% crospovidone, 10%
mannitol, 10% microcrystalline cellulose, 7.5% polyethylene
oxide, 3.5% sodium bicarbonate, 3.3% tartaric acid, 2% colloi-
dal silicon dioxide, and 1% magnesium stearate. The almond-
shaped, white to off-white colored tablet measured 1.9 ·
0.55 cm and was supplied as 10 tablets in a bottle (Fig. 1C).
In vitro studies show that, in general, the placebo tablets
used in this research dissolve in < 30 minutes in water and the
placebo films dissolve in < 15 minutes, also in water (un-
published data). It is unknown, however, how applicable or
relevant the in vitro data are to actual use in women.
Statistics
Standard t tests of statistical significance were used to as-
sess differences between products, countries, and key sub-
groups. Significant differences met the 95% confidence level
(95% CL) criterion, unless otherwise specified.
The study was designed such that countries were the key
subgroups. Data were analyzed by age, SES, and marital
status, with the understanding that country-specific results
for these subgroups have limited statistical reliability because
of their small size. The intent was to represent the majority of
the target population under the assumption that preferences
among surveyed women would be similar to those who lived
FIG. 1. Placebo dosage forms used in the study. (A) The translucent, off-white placebo film was manufactured by MonoSol
(Merrillville, IN), measured 2.0 · 1.0 cm, and was supplied in individual sealed wrappers. (B) The clear, oval-shaped soft-gel
capsule (SGC) was K-YÒ LiquibeadsÔ (McNeil-PPC, Fort Washington, PA), measured 2.5 · 1.25 cm, and was supplied in
individual blister packs. (C) The almond-shaped, white to off-white colored placebo tablet was manufactured by Azopharma
(Miramar, FL), measured 1.9 · 0.55 cm, and was supplied as 10 tablets in a bottle.
1208 NEL ET AL.
3. in areas not included in the study. The study covered urban
and semiurban but not rural areas, and the poorest women
were underrepresented.
To achieve a 95% CL that does not exceed – 8% for key
subgroups (country-specific results) and – 5% for the total
sample, the goal was to have a minimum of 150 completed
surveys per country. The 95% confidence intervals (CI) for
n = 150 (country-specific goal) and n = 450 (total sample goal)
are – 8% and – 4.6%, respectively. The actual sample size
(526 total, 172–179 per country) exceeds these desired mini-
mum requirements.
Results
Disposition
A total of 2329 women were screened for participation in
the study, 377 at two locales in Burkina Faso, 535 at two lo-
cales in Tanzania, and 1417 at two locales in Zambia. Before
the first product was placed, 1761 women were disqualified
from the study: approximately 30% declined to participate,
and the remaining women did not meet the enrollment cri-
teria, mostly because their age was outside the specified age
range or the quotas for their age, marital status, or socioeco-
nomic group were already met in the particular market. Forty-
two women discontinued their participation in the study after
testing one or more products, usually because they did not
like the product. Not counting these women, a total of 526
women participated in the study, 172 in Burkina Faso, 179 in
Tanzania, and 175 in Zambia.
Demographics
Demographic characteristics (age, marital status, SES) were
similar across countries (Table 1).
Product usage
Study participants were given a 7-day supply (10 appli-
cations) of each product and instructed to use one appli-
cation daily for 7 days. Results include all women who used
all three products three or more times and used at least
two products four or more times. The majority of women
in each country (89%–93% in Burkina Faso, 82%–88% in
Tanzania, and 79%–86% in Zambia) used six to seven ap-
plications of each product. Participants were asked, but not
required, to use at least one weekly application within 1
hour before having sexual intercourse. For each dosage
form, less than half of all women (46%) followed this sug-
gestion, especially in Burkina Faso, where the percentage
was significantly lower (27%–30%) than in the other two
countries (47%–62%).
Product ratings
When asked to assess each product individually, > 80% of
women reported that they liked using each dosage form
(Fig. 2A). Using the film was liked ‘‘a lot’’ by significantly
more women (61%) than the SGC (53%) or tablet (49%). When
asked to choose their favorite dosage form, the film and SGC
were chosen significantly more often than the tablet (Fig. 2B).
Preferred vaginal dosage form varied by country; women in
Burkina Faso and Tanzania preferred the SGC (42%–46%),
whereas Zambian women preferred the film (51%) (Fig. 2C).
There were no statistically significant differences in dosage
form preferences between younger (18–24 years) and older
(25–30 years) women in any of the three countries. Similarly,
there were no significant differences in preferences for women
of lower vs. higher SES. With one exception, the same was true
for marital status; single women in Tanzania preferred the
Table 1. Demographic Data
Burkina Faso Tanzania Zambia Total
n = 172 n = 179 n = 175 n = 526
Characteristic n (%) n (%) n (%) n (%)
Age, yearsa
18–21 34 (19.8) 39 (21.8) 32 (18.3) 105 (20.0)
22–24 49 (28.5) 49 (27.4) 52 (29.7) 150 (28.5)
25–27 55 (32.0)d
40 (22.3) 43 (24.6) 138 (26.2)
28–30 34 (19.8) 51 (28.5) 48 (27.4) 133 (25.3)
Marital statusb
Married or living with partner 83 (48.3) 93 (52.0) 88 (50.3) 264 (50.2)
Single, divorced, widowed 89 (51.7) 86 (48.0) 87 (49.7) 262 (49.8)
Socioeconomic statusc
Upper 85 (49.4) 87 (48.6) 86 (49.1) 258 (49.0)
Lower 87 (50.6) 92 (51.4) 89 (50.9) 268 (51.0)
No. of children < 18 in household
None 13 (7.6) 34 (19.0)e,f
13 (7.4) 60 (11.4)
1–2 77 (44.8) 107 (59.8)e,f
78 (44.6) 262 (49.8)
3–4 54 (31.4)d
27 (15.1) 59 (33.7)d
140 (26.6)
5 + 28 (16.3)d
11 (6.1) 25 (14.3)d
64 (12.2)
a
By design, approximately half of participants in each country were 18–24 years of age and half were 25–30 years. Quotas were not set for
more granular age bands.
b
By design, approximately half of participants in each country were married/living together and half were single/divorced/widowed.
c
Socioeconomic status was determined based on education, home ownership, job type, and ownership of household property. By design,
approximately half of participants in each country were of lower and half were of higher socioeconomic status.
dSignificantly higher than Tanzania.
e
Significantly higher than Burkina Faso.
f
Significantly higher than Zambia.
ACCEPTABILITY OF VAGINAL DOSAGE FORMS 1209
4. vaginal tablet significantly more often than their married
counterparts.
Product characteristics
The majority of women (64%–73%) felt that each dosage
form tested was very easy to insert; the percentages were
significantly greater for the SGC and tablet than for the film
(Fig. 3A). Tanzanian women rated insertion ‘‘very easy’’ sig-
nificantly less often (54%–65%) than women from Zambia
(70%–77%) or Burkina Faso (67%–79%). For women who
rated the dosage forms as difficult to insert (21%–28%), most
agreed that insertion became easier with time (61%–66%);
70%–79% of these women thought insertion was easier after
two or three applications.
Most women (84%–91%) believed that the products stayed
in place every time they were inserted; the percentages were
significantly lower for Tanzanian women (70%–83%) than for
women in Zambia (85%–94%) or Burkina Faso (94%–98%).
Although using product applicators was not an option in this
study, participants were asked if they would have preferred
using one with each dosage form. Over half (58%–61%) re-
sponded that they prefer inserting each dosage form by hand
vs. using an applicator (28%–31%); however, a significantly
greater percentage of women in Tanzania (36%–42%) than
Zambia (22%–25%) or Burkina Faso (20%–28%) responded
that they would prefer using an applicator with each product.
Most women thought that the size of the film and tablet were
just right (74% and 67%, respectively), although half (51%)
indicated that the SGC was too big.
FIG. 2. Vaginal dosage form ratings and preferences. Sexually active women (172 in Burkina Faso, 179 in Tanzania, and 175
in Zambia) were instructed to use placebo formulations of each of three vaginal products (film, soft-gel capsule [SCG], and
tablet) once daily for 7 consecutive days for a total of 21 days. Women were queried about their impressions of the products
at the end of each 7-day trial period. Data on participants’ opinions about using each dosage form are presented in (A). Data
on preferred dosage forms are shown for total participants in (B) and by country in (C). *Significantly greater than tablet at
the 95% CL. {Significantly greater than SGC at the 95% CL. {Significantly greater than film at the 95% CL.
1210 NEL ET AL.
5. Significantly greater percentages of women felt that the
dissolving time for the film and SGC were just right compared
with the dissolving time of the tablet, which was considered
too long by 38% of testers (Fig. 3B).
Compared with the other two dosage forms, significantly
more women believed that there was no leakage with the film
(45%) than with the SGC and tablet (14% and 26%, respec-
tively) (Fig. 3C); however, significantly more women in
Zambia (72%) than Burkina Faso or Tanzania (32% each) felt
this way. Leakage was assessed as much too much signifi-
cantly more often with the SGC than with the film or tablet
(19% vs. 3%, 11%).
Significantly more women did not feel the film inside (57%)
compared with the other two dosage forms (35%–38%). Most
women who felt the product inside described the feeling as
‘‘not uncomfortable at all.’’ The film was described this way
significantly more often than the other two products (63% vs.
51%–54%). At least half of testers (50%–59%) claimed that the
products increased their sexual pleasure, whereas 33%–43%
thought the products had no impact on their sexual pleasure.
Significantly more women felt the texture of the film (54%)
and SGC (48%) were just right compared with the tablet
(41%), which was considered too rough by 37% of women. No
odor/fragrance was reported for each product by 66%–79% of
responders. The color of each product was liked a lot by the
majority of women (80%–85%).
Likelihood to use product
At least 85% of women in each country stated they would
definitely use the film, and 87%–91% of women in Burkina
Faso and Tanzania said they would definitely use the other
two dosage forms as well, compared with 77%–80% of
Zambian women (Fig. 4).
Among women who had sexual intercourse during the
product usage period, the percentage whose male partner was
aware of product use was significantly higher in Zambia
(45%) than in Burkina Faso (31%) or Tanzania (27%). Partners
of married women (or women living with their partners) were
significantly more likely to be aware of product usage than
partners of single women (45% vs. 21%). Age and SES did not
significantly influence male awareness of product use.
Male partners’ opinions
Women whose partners were aware of product use and
had intercourse with them during the product usage period
(34 of 172 women in Burkina Faso, 40 of 179 women in Tan-
zania, and 58 of 175 women in Zambia) were asked how much
their male partners liked them using the product. Over half
(54%–62%) reported that their partners liked them using the
products (Fig. 5). According to participant reports, signifi-
cantly more male partners in Tanzania liked them using the
film (76%) and SGC (81%) than in Burkina Faso (49%, 47%)
and Zambia (52%, 59%). Overall, significantly more men
disliked the tablet (19%) than the film (7%) or SGC (9%).
Only 31 male sexual partners of 526 study participants
completed a quantitative survey: 3 from Burkina Faso, 25
from Tanzania, and 3 from Zambia. The majority of these 31
men (71%–74%) reported that they could feel each product
during sex. Significantly more men (61%) preferred the SGC
over the tablet (16%) or film (19%). The SGC was reported to
increase the man’s sexual pleasure (71%), although 77%
FIG. 3. Characteristics of vaginal dosage forms. After using
each of three vaginal dosage forms for 7 consecutive days,
sexually active women in Burkina Faso (n = 172), Tanzania
(n = 179), and Zambia (n = 175) were queried about their im-
pressions of the product characteristics. Data on ease of
product insertion are shown in (A). Data on perceived time
for product dissolution are shown in (B). A perceived dis-
solve time £ 10 minutes was reported by 45.2% of respon-
dents who used the film, compared with 36.9% of those who
used the SGC and 29.8% of those who used the tablet. At the
other end of the continuum, 22.8% of the women who used
the tablet said it took > 30 minutes to dissolve, compared
with 12.2% of those who used the SGC and 5.1% of those
who used the film. Data on product leakage are shown in
(C). Overall, 14.4% of women using the SGC reported no
leakage, compared with 25.7% of those using the tablet and
45.4% of those using the film. *Significantly greater than
tablet at the 95% CL. {
Significantly greater than SGC at the
95% CL. {Significantly greater than film at the 95% CL.
ACCEPTABILITY OF VAGINAL DOSAGE FORMS 1211
6. thought it provided too much lubrication. A lower percentage
of men reported that the film increased their sexual pleasure
(55%), and 42% believed that the tablet decreased their plea-
sure. The amount of lubrication provided by the film was
considered just right by 58% of male responders; 48% re-
ported that the tablet provided too little lubrication. In a male
focus group in Morogoro, Tanzania (n = 12), many men
commented that they preferred the film because it made the
vagina feel dry, which provided more pleasure for them
during sexual intercourse. They also liked that the film had
minimal leakage during and after sex.
Discussion
The film, SGC, and tablet were acceptable vaginal dosage
forms to > 80% of the women surveyed in Burkina Faso,
Tanzania, and Zambia, and 77%–91% of women in each
country stated they would definitely use each product if it
were proven effective against HIV transmission. Favorite
dosage forms varied by country: SGC and film in Burkina
Faso, SGC in Tanzania, and film in Zambia. Age, SES, and
marital status did not affect these preferences.
The film scored highly mainly because the size, texture, and
dissolving time were considered just right, and leakage was
minimal. We report that 89% of African women who used the
placebo vaginal film liked using it, and 87% said they would
definitely use a vaginal film for protection against HIV in-
fection. This is similar to the percentage of American women
(81% of 273),5
South African women (75% of 20),6
and Ca-
meroonian women ( > 80% of 520)7 who liked using the N-9
spermicidal film. In our study, 72% of African women found
the placebo film easy to insert, 28% found it difficult to insert
because it stuck to the fingers, and some women thought an
applicator would be beneficial. In studies with the N-9 film,
no South African women6
and 76% of American women5
re-
ported difficulty with film insertion. Leakage was reported by
55% of placebo film users in our study compared with 23% of
American N-9 film users who reported leakage or messiness.5
Almost all (97%) users of the placebo film thought that the
product increased or had no effect on their own sexual plea-
sure compared with 86% of American N-9 film users.5
Seven
percent of women surveyed said their male sex partners dis-
liked them using the placebo film compared with 20% of
American women who reported partner dissatisfaction with
the N-9 film.5
Differences in acceptability ratings between the N-9 vaginal
film and the placebo vaginal film tested here could have been
due in part to the different chemical compositions of the
products. Although both products were composed primarily
of polyvinyl alcohol and glycerin,10
the placebo film had four
additional components (hydroxypropyl methylcellulose,
polyethylene glycol, croscarmellose sodium, and propylene
glycol). In addition, the dosing regimens varied across stud-
ies. In the American study, the N-9 film was used at the time of
intercourse for 7 months; in the South African study, the N-9
film was used two to five times daily for 1 month; in the
Cameroon study, the N-9 film was used at the time of inter-
course for 14 months; and in the study reported here, the
placebo film was used once daily for 7 days. Perceptions
about the product indication (contraception vs. HIV preven-
FIG. 4. Willingness to use vaginal dosage form in the future.
After using each of three vaginal dosage forms for 7 consec-
utive days, sexually active women in Burkina Faso (n = 172),
Tanzania (n = 179), and Zambia (n = 175) were queried about
their willingness to use a microbicide vaginal film, SGC, and
tablet in the future if proven to be effective against transmis-
sion of HIV infection and affordable. The results are shown for
each dosage form by country. *Significantly greater than
tablet in the same country at the 95% CL. {Significantly greater
than SGC in the same country at the 95% CL. {
Significantly
greater than Zambia at the 95% CL.
FIG. 5. Male sexual partner’s opinion of woman using product as reported by participants. Women whose partners were
aware of product use and had intercourse with them during the product usage period (34 of 172 women in Burkina Faso, 40
of 179 women in Tanzania, and 58 of 175 women in Zambia) were asked how much their male partners like them using the
product. The results are shown by dosage form. *Significantly greater than SGC at the 95% CL. {
Significantly greater than
film at the 95% CL.
1212 NEL ET AL.
7. tion) and cultural differences between study populations also
could have affected product acceptability. For example, South
African N-9 film users liked the fact that the film made their
vagina feel tight and dry,6
a culturally desirable trait.11–16
The results of a questionnaire completed by a limited
number of male sexual partners of study participants (n = 31)
showed that the men preferred the SGC over the other two
dosage forms. It is important to note, however, that 81% of
these men were from Tanzania, where a greater percentage of
women reported that their male partners liked the SGC (81%)
than in Burkina Faso (47%) or Zambia (59%) (Fig. 5). The SCG
was considered significantly easier to insert than the other
two forms but was perceived by some as containing too much
gel, resulting in excessive lubrication and leakage. It is im-
portant to note that the SGC used in this study (K-YÒ Liqui-
beadsÔ) was designed as a vaginal lubricant to last up to 4
days and, therefore, may not be directly comparable with a
microbicide SGC. From the male perspective, the extra lu-
brication provided by the SGC was both a positive and neg-
ative characteristic. Although the majority of men (77%)
thought that the SGC provided too much lubrication, 71%
believed the product increased their own sexual pleasure, and
significantly more men (63%) liked the SGC best when com-
pared with the film (20%) or tablet (17%). From the female
perspective, 37% liked the SGC best (vs. 39% film and 25%
tablet), and 59% thought that the SGC increased their own
sexual pleasure.
The major disadvantages of the tablet were the dissolution
time (too long) and the texture, which was considered a little
too rough by some study participants. Seventy-four percent of
526 African women reported leakage with daily use of the
placebo tablet. In an acceptability study with an investiga-
tional HIV microbicide, Praneem polyherbal vaginal tablet,
45% of 20 Indian women who used the product daily for 14
days reported product leakage after sex.8 These women and
women in our study stated that product leakage would not
deter them from using the vaginal tablet in the future for HIV
protection. More Indian women (95%) found the Praneem
tablet easy to insert than African women who used the pla-
cebo tablet (79%); neither tablet was administered with an
applicator. Similar percentages of Indian women (95%) and
African women (93%) believed that their own sexual pleasure
was increased or not affected by use of the vaginal tablet. In a
phase II study with Praneem tablet, 93% of 95 Indian women
who used the active or placebo product at the time of inter-
course for 6 months reported male partner acceptability of
product use9
compared with 54% of 526 African women, who
reported here that their male partners liked them using the
placebo tablet daily for 7 days. Differences in acceptability
ratings for the two vaginal tablets could be due to the very
different chemical compositions,17 to different dosing regi-
mens, or to cultural differences between India and Africa.
In Burkina Faso, Tanzania, and Zambia, participants pre-
ferred that their male sexual partner did not know that they
were using a vaginal product. Some worried that he would
not allow them to use it or would become angry with them.
Most women (74%–97%) did not want their male partners
contacted for an interview about product use (data not
shown). Women were confident that they could use each
product without their partner knowing. Nearly two thirds
(66%) of the women who had sexual intercourse during
product use did not tell their partners they were using the
product. Male partners married to or living with the partici-
pants were more likely to know about product use than
partners of single women (45% vs. 21%). When male partners
knew about product use, 54%–62% of women reported that
the man liked them using the product.
Similar comments were made by women who participated
in earlier HIV prevention studies with the N-9 vaginal film or
Praneem polyherbal vaginal tablet. Female sex workers (FSW)
in Cameroon reported that they liked the ability to use the film
discreetly (without their client’s knowledge) and the fact that
use of the product was under female control.7
FSW in South
Africa did not inform their clients about N-9 film use, but 50%
informed their regular sex partner and did not experience any
problems with the disclosure.6
Indian women who used
Praneem polyherbal tablet thought that other Indian women
would like the fact that use of the product was female initi-
ated; however, both Indian men and women had concerns
about using HIV prevention products covertly.8
Conclusions
All three placebo dosage forms were acceptable to sexually
active adult women surveyed in Burkina Faso, Tanzania, and
Zambia. Preferred dosage forms varied by country. These
data suggest that the availability of microbicides in multiple
dosage forms may increase acceptability, adherence, and,
therefore, effectiveness in a wide variety of women.
Acknowledgments
We wish to acknowledge Dr. Youssef Tawfik as Principal
Investigator, Equilibres & Populations for assistance with
implementation of the study in Burkina Faso, Anne Schley for
assistance with data collection and analysis, Shanique Smythe
for project management, Iman Ahmad for assistance with
study conduct, Dr. Lisa Rohan and Dr. Sanjay Garg for design
of the placebo formulations and their contributions to product
availability for the study as well as for their assistance with
development of survey questions, Dr. Sandhya Singh for
contributions to formulation development and manufactur-
ing of the placebo dosage forms, Luciana Maxim for assis-
tance with technical writing, and Dr. Paulina Kaptur for
preparation of the manuscript.
Disclosure Statement
No competing financial interests exist.
References
1. World Health Organization. The global burden of disease,
2004 update. Geneva: World Health Organization, 2008.
2. Romano J, Malcolm RK, Garg S, Rohan LC, Kaptur PE.
Microbicide delivery: Formulation technologies and strate-
gies. Curr Opin HIV AIDS 2008;3:558–566.
3. Lete I, Doval JL, Perez-Campos E, et al. Factors affecting
women’s selection of a combined hormonal contraceptive
method: The TEAM-06 Spanish cross-sectional study. Con-
traception 2007;76:77–83.
4. Creinin MD, Meyn LA, Borgatta L, et al. Multicenter com-
parison of the contraceptive ring and patch: A randomized
controlled trial. Obstet Gynecol 2008;111:267–277.
5. Raymond EG, Chen PL, Condon S, et al. Acceptability of five
nonoxynol-9 spermicides. Contraception 2005;71:438–442.
ACCEPTABILITY OF VAGINAL DOSAGE FORMS 1213
8. 6. Rustomjee R, Karim QA, Karim SSA, Laga M, Stein Z. Phase
1 trial of nonoxynol-9 film among sex workers in South
Africa. AIDS 1999;13:1511–1515.
7. Visness CM, Ulin P, Pfannenschmidt S, Zekeng L. Views of
Cameroonian sex workers on a woman-controlled method
of contraception and disease prevention. Int J STD AIDS
1998;9:692–699.
8. Joglekar NS, Joshi SN, Navlakha SN, Katti UR, Mehendale
SM. Acceptability of Praneem polyherbal vaginal tablet
among HIV uninfected women & their male partners in
Pune India—Phase I study. Indian J Med Res 2006;123:547–
552.
9. Joglekar NS, Joshi SN, Deshpande SS, Parkhe AN, Katti UR,
Mehendale SM. Acceptability and adherence: Findings from
a phase II study of a candidate vaginal microbicide, Praneem
polyherbal tablet, in Pune, India. Trans R Soc Trop Med Hyg
2010;104:412–415.
10. Raymond EG, Chen PL, Luoto J, for the Spermicide Trial
Group. Contraceptive effectiveness and safety of five
nonoxynol-9 spermicides: A randomized trial. Obstet Gy-
necol 2004;103:430–439.
11. Gafos M, Mzimela M, Sukazi S, Pool R, Montgomery C,
Elford J. Intravaginal insertion in KwaZula-Natal: Sexual
practices and preferences in the context of microbicide gel
use. Cult Health Sex 2010;12:929–942.
12. Hilber AM, Hull TH, Preston-Whyte E, et al. A cross cultural
study of vaginal practices and sexuality: Implications for
sexual health. Soc Sci Med 2010;70:392–400.
13. Smit J, Chersich MF, Beksinska M, et al. Prevalence and
self-reproted health consequences of vaginal practices in
KwaZulu-Natal, South Africa: Findings from a household
survey. Trop Med Int Health 2010 Nov 23 doi: 10.1111/
j.1365–3156.2010.02687.x [Epub ahead of print].
14. Beksinska ME, Rees HV, Kleinschmidt I, McIntyre J. The
practice and prevalence of dry sex among men and women
in South Africa: A risk factor for sexually transmitted in-
fections? Sex Transm Infect 1999;75:178–180.
15. Civic D, Wilson D. Dry sex in Zimbabwe and implications
for condom use. Soc Sci Med 1996;42:91–98.
16. Brown JE, Ayowa OB, Brown RC. Dry and tight: Sexual
practices and potential AIDS risk in Zaire. Soc Sci Med
1993;37:989–994.
17. Joshi SN, Dutta S, Kumar BK, et al. Expanded safety study of
Praneem polyherbal vaginal tablet among HIV-uninfected
women in Pune, India: A phase II clinical trial report. Sex
Transm Infect 2008;84:343–347.
Address correspondence to:
Annalene M. Nel, MBChB, Ph.D.
International Partnership for Microbicides
8401 Colesville Road, Suite 200
Silver Spring, MD 20910
E-mail: anel@ipmglobal.org.za
1214 NEL ET AL.