Stockman Jamila K, Syvertsen Jennifer L, Robertson Angela M, Ludwig-Barron Natasha T, Bergmann Julie N, Palinkas Lawrence A
Division of Global Public Health, Department of Medicine, School of Medicine, University of California, San Diego, La Jolla, California.
Department of Anthropology, College of Arts and Sciences, Ohio State University, Columbus, Ohio.
Womens Health Issues. 2014 Jul-Aug;24(4):e397-405. doi: 10.1016/j.whi.2014.04.001. Epub 2014 May 14.
Female-initiated barrier methods for the prevention of HIV may be an effective alternative for drug-using women who are unable to negotiate safe sex, often as a result of physical and/or sexual partner violence.
Utilizing a SAVA (substance abuse, violence, and AIDS) syndemic framework, we qualitatively examined perspectives on female condoms and vaginal microbicides among 18 women with histories of methamphetamine abuse and partner violence in San Diego, California.
Most women were not interested in female condoms owing to perceived discomfort, difficulty of insertion, time-intensive effort, and unappealing appearance. Alternatively, most women viewed vaginal microbicides as a useful method. Positive aspects included convenience, ability to disguise as a lubricant, and a sense of control and empowerment. Concerns included possible side effects, timing of application, and unfavorable characteristics of the gel. Acceptability of female-initiated barrier methods was context dependent (i.e., partner type, level of drug use and violence that characterized the sexual relationship).
Findings indicate that efforts are needed to address barriers identified for vaginal microbicides to increase its uptake in future HIV prevention trials and marketing of future Food and Drug Administration-approved products. Strategies should address gender-based inequalities (e.g., partner violence) experienced by drug-using women and promote female empowerment. Education on female-initiated barrier methods is also needed for women who use drugs, as well as health care providers and other professionals providing sexual health care and contraception to women with histories of drug use and partner violence.
对于那些常常因身体暴力和/或性伴侣暴力而无法协商安全性行为的吸毒女性而言，由女性主动使用的预防艾滋病毒的屏障方法可能是一种有效的替代方法。
利用药物滥用、暴力和艾滋病综合征框架，我们对加利福尼亚州圣地亚哥18名有甲基苯丙胺滥用史和伴侣暴力史的女性关于女用避孕套和阴道杀菌剂的观点进行了定性研究。
大多数女性对女用避孕套不感兴趣，原因是感觉不舒服、插入困难、耗时费力以及外观缺乏吸引力。相反，大多数女性认为阴道杀菌剂是一种有用的方法。其积极方面包括方便、可伪装成润滑剂以及有控制感和自主感。担忧包括可能的副作用、使用时间以及凝胶的不良特性。女性主动使用的屏障方法的可接受性取决于具体情况（即伴侣类型、药物使用水平以及性关系中的暴力程度）。
研究结果表明，需要努力解决已确定的阴道杀菌剂的障碍，以便在未来的艾滋病毒预防试验中提高其使用率，并促进美国食品药品监督管理局未来批准产品的销售。策略应解决吸毒女性所经历的基于性别的不平等问题（如伴侣暴力），并促进女性赋权。对于吸毒女性以及为有吸毒史和伴侣暴力史的女性提供性健康护理和避孕服务的医疗保健提供者及其他专业人员，也需要开展关于女性主动使用的屏障方法的教育。
