The acceptability of a vaginal microbicide among South African men

Context: With the explosive nature of the South African AIDS epidemic, ther e is an urgent need for HIV prevention methods controlled by women. Because several microbicide trials are going on in South Africa and elsewhere, the re also is an urgent need to determine South African men's perceptions of a nd preferences for a potential vaginal microbicide. Methods: Two hundred and forty-three men were recruited from three sites in South Africa: sexually transmitted disease (STD) clinics (N=95), the gener al population (N=98) and universities (N=50). A brief demonstration of a po tential vaginal gel microbicide was followed by a private interview, which included questions about men's demographic characteristics, sexual activiti es, condom use and willingness to support their partner's use of a vaginal product. Results: The mean ages of men from STD clinics, the general population and universities were 30, 28 and 23 years, respectively. Forty-five percent of men from STD clinics, 69% from the general population and 65% of the univer sity students reported a dislike for male condoms. More than 80% of the ent ire sample wanted their partner to be protected against HIV a nd other STDs . The majority of the men in the three groups (77-87%) would like their par tner to use a microbicide and 66-82% said they would like to be involved in the decision to use a microbicide. Men were more likely to express a prefe rence for microbicides than for condoms. In addition, they were more likely to prefer a vaginal product that prevents HIV and STD transmission and doe s not act as a contraceptive than one that acts only as a contraceptive. Th e majority (58-67%) of men reported that excess lubrication was not a desir ed product characteristic. Conclusions: Vaginal microbicides may be acceptable to South African men. T he amount of lubrication provided by the product and noninterference with s exual pleasure may be keys to product acceptability. Preference for an effe ctive noncontraceptive microbicide was greater than for a contraceptive pro duct.