OA02.03
Background: Disclosure of product use has been shown to influence adherence in microbicide trials. We explored disclosure in the context of CAPRISA 008, an ongoing open-label follow-on trial of 1% tenofovir gel enrolling uninfected CAPRISA 004 trial participants.
Methods: In-depth interviews (n=63) and focus groups (n=8) were held with CAPRISA 008 participants; male partners of 13 women who fully disclosed trial participation and gel use were also interviewed. Four focus groups were held with community men who were not partners of CAPRISA 008 participants.
Results: Most CAPRISA 008 participants interviewed told their partner at least some details about being in the trial or use of the gel. Motivating factors for disclosure included perceived difficulty in hiding gel from a partner and a desire to inform others about the benefits of the gel. Women disclosing gel use to a partner perceived it easier to adhere to the coitally-related regimen. Male partners of disclosers described feelings of initial fear and apprehension of the gel followed by gradual acceptance after being more fully informed. Non-disclosing women described the ease of hiding gel use from their partners. Barriers to disclosure included fear that the partner would not understand her motivations for using the gel for HIV prevention or that he would react negatively to her use of an intravaginal product. Community men saw disclosure as indicative of the quality and seriousness of a relationship: women in casual relationships could use gel without disclosing while those in stable relationships should discuss gel use because non-disclosure inferred lack of trust. Community men felt that counselors and pharmacists could assist women in explaining the purpose and use of the gel to their partner.
Conclusions: Disclosure of 1% tenofovir gel use is perceived as beneficial by women and men when it is negotiated and socially supported. Non-disclosure is a practical and acceptable option in some relationships.
