SILCS Diaphragm as a multipurpose prevention technology: New data from South Africa
ESC Congress Library. Kilbourne - Brook M. 05/04/16; 126882; A-056
Ms. Maggie Kilbourne - Brook
Ms. Maggie Kilbourne - Brook
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Abstract
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Background: The SILCS Diaphragm is a single-size, reusable contraceptive developed through a user centered process to be easy to use and comfortable for both partners. The innovative design eliminates the need for a pelvic exam to determine diaphragm size. Researchers are now assessing the SILCS Diaphragm as a reusable delivery system for microbicide gel. If acceptable, the SILCS gel delivery system could protect from both unintended pregnancy and HIV/STIs, thus serving as a multipurpose prevention technology (MPT).

Objective: Assess the acceptability and preference for the SILCS Diaphragm used for (microbicide) gel delivery compared to gel delivery from a prefilled applicator.

Method: A randomized, crossover study among 115 women in Durban, South Africa. Data were collected via coital logs, questionnaires, and focus group discussions with women and male partners. Literate, sexually active, nonpregnant women, 18‒45 years, in a monogamous relationship for at least six months, using a nonbarrier method of contraception were eligible. Women used each method during five separate sex acts. Acceptability and preference endpoints were summarized by delivery system using means and medians (for continuous measures) and frequencies and percentages (for discrete outcomes). Acceptability scores ranked on a 5-point scale were compared for both gel delivery scenarios using Friedman’s test.

Results: 115 black women, aged 18‒44, were enrolled; 106 (92%) completed the study. Most women reported good comfort with the SILCS Diaphragm during intercourse (85%) and also felt comfortable after 2‒3 insertions (83%), similar to the learning curve for applicator use.

Women reported good comfort overall (gel and delivery system together), with slightly more reporting applicator/gel was 'very acceptable' (68%) compared to SILCS and gel (60%).

While 18% of women reported they would use the SILCS for pregnancy prevention and 14% would use a microbicide for HIV prevention, 68% were interested in using SILCS plus gel if it could protect from both unintended pregnancy and HIV.

Conclusions: This study expands knowledge about South African women’s experience with the SILCS Diaphragm as a contraceptive and as a potential MPT, and may have implication for women in other countries as well. These results confirm that women can easily learn to use the SILCS Diaphragm; they find SILCS comfortable during use; and they and their partners experience acceptable sex while using SILCS. Women in this study recognized a benefit of using the SILCS Diaphragm and microbicide gel as a potential MPT, and this greatly increased women’s interest in using this method.

Background: The SILCS Diaphragm is a single-size, reusable contraceptive developed through a user centered process to be easy to use and comfortable for both partners. The innovative design eliminates the need for a pelvic exam to determine diaphragm size. Researchers are now assessing the SILCS Diaphragm as a reusable delivery system for microbicide gel. If acceptable, the SILCS gel delivery system could protect from both unintended pregnancy and HIV/STIs, thus serving as a multipurpose prevention technology (MPT).

Objective: Assess the acceptability and preference for the SILCS Diaphragm used for (microbicide) gel delivery compared to gel delivery from a prefilled applicator.

Method: A randomized, crossover study among 115 women in Durban, South Africa. Data were collected via coital logs, questionnaires, and focus group discussions with women and male partners. Literate, sexually active, nonpregnant women, 18‒45 years, in a monogamous relationship for at least six months, using a nonbarrier method of contraception were eligible. Women used each method during five separate sex acts. Acceptability and preference endpoints were summarized by delivery system using means and medians (for continuous measures) and frequencies and percentages (for discrete outcomes). Acceptability scores ranked on a 5-point scale were compared for both gel delivery scenarios using Friedman’s test.

Results: 115 black women, aged 18‒44, were enrolled; 106 (92%) completed the study. Most women reported good comfort with the SILCS Diaphragm during intercourse (85%) and also felt comfortable after 2‒3 insertions (83%), similar to the learning curve for applicator use.

Women reported good comfort overall (gel and delivery system together), with slightly more reporting applicator/gel was 'very acceptable' (68%) compared to SILCS and gel (60%).

While 18% of women reported they would use the SILCS for pregnancy prevention and 14% would use a microbicide for HIV prevention, 68% were interested in using SILCS plus gel if it could protect from both unintended pregnancy and HIV.

Conclusions: This study expands knowledge about South African women’s experience with the SILCS Diaphragm as a contraceptive and as a potential MPT, and may have implication for women in other countries as well. These results confirm that women can easily learn to use the SILCS Diaphragm; they find SILCS comfortable during use; and they and their partners experience acceptable sex while using SILCS. Women in this study recognized a benefit of using the SILCS Diaphragm and microbicide gel as a potential MPT, and this greatly increased women’s interest in using this method.

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