McLellan-Lemal E, Ondeng'e K, Gust D A, Desai M, Otieno F O, Madiega P A, Nyagol B, Makanga E M
Centers for Disease Control and Prevention, Office of Infectious Diseases, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia-USA.
Kenya Medical Research Institute, Kisumu, Kenya.
Front Womens Health. 2017 Mar;2(1). doi: 10.15761/FWH.1000122. Epub 2017 Feb 16.
Future HIV prevention options for women will likely include Antiretroviral (ARV)-based intravaginal rings. Valuable insights may be gained by examining user experiences with a similar licensed technology, a contraceptive ring, especially in settings where this technology may not be currently available.
In-depth interviews with 24 females enrolled in a trial assessing acceptability and use of a contraceptive ring, and 20 male sexual partners were conducted September 2014-April 2015. Elements of ethnography and phenomenological anthropology were used to collect, analyze, interpret, and describe ring users' experiences. Thematic analysis was completed in MaxQDA-10.
Experiences with the contraceptive ring reflected a broader Family Planning (FP) paradigm that centered around three themes: latitudes and drawbacks of FP (being free); an FP method needs to be compatible with a woman's body (feeling normal); and dealing with fertility control uncertainties (how well does it really work). FP intentions and disclosure practices were influenced by partner support, socioeconomic factors, religion, cultural beliefs, and societal norms, including female sexuality. A user-friendly FP design was emphasized. Non-suppression of menstruation was favored by most. Unease with vaginal insertion as well as ring placement issues (slippage, expulsion) created initial challenges requiring clinician assistance and practice for some participants. While minor side-effects were described, concerns centered on ring efficacy, negative effect on a woman's sexual desire, and future fertility issues.
Awareness of the multiple contexts in ring users' experience may inform the development, education, and promotion approaches for future ARV rings.
未来针对女性的艾滋病预防方案可能会包括基于抗逆转录病毒药物（ARV）的阴道环。通过研究用户对类似的已获许可技术（避孕环）的使用体验，尤其是在当前可能无法获得该技术的环境中，可以获得有价值的见解。
2014年9月至2015年4月，对24名参与评估避孕环可接受性和使用情况试验的女性以及20名男性性伴侣进行了深入访谈。运用人种志和现象学人类学的方法来收集、分析、解释和描述避孕环使用者的体验。在MaxQDA-10中完成了主题分析。
避孕环的使用体验反映了一个更广泛的计划生育（FP）模式，该模式围绕三个主题：计划生育的优势和缺点（免费）；一种计划生育方法需要与女性身体相适应（感觉正常）；以及应对生育控制的不确定性（它实际效果如何）。计划生育的意图和披露做法受到伴侣支持、社会经济因素、宗教、文化信仰和社会规范（包括女性性行为）的影响。强调了设计方便用户的计划生育产品。大多数人赞成不抑制月经。阴道插入以及环的放置问题（滑落、排出）给一些参与者带来了最初的挑战，需要临床医生的协助和练习。虽然描述了一些轻微的副作用，但关注点集中在环的功效、对女性性欲的负面影响以及未来的生育问题上。
了解避孕环使用者体验中的多种情况可能会为未来抗逆转录病毒阴道环的开发、教育和推广方法提供参考。
