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Huang JL, Xin X, Ma MJ, Ning Z, Xiao ST, Chen PP. A qualitative study on the clinical safety and user experiences of female condoms for anal intercourse among men who have sex with men in Shanghai, China. Front Public Health 2023; 11:1243891. [PMID: 38074717 PMCID: PMC10701689 DOI: 10.3389/fpubh.2023.1243891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/19/2023] [Indexed: 12/18/2023] Open
Abstract
Objective This qualitative study aimed to understand the clinical safety, efficacy, and receptiveness of using the female condom (FC) during anal intercourse among men who have sex with men (MSM). Methods Subjects for this study were recruited from a two-group crossover trial among MSM in Shanghai. The trial consisted of two phases, each including the use of condoms (FC vs. male condom), questionnaires, and in-depth one-on-one interviews. The two phases were separated by a washout period of 4 weeks. The minimum sample size for this study was determined in accordance with the principle of "information saturation." The qualitative data were organized and analyzed using ATLAS.ti version 7. Results A total of 26 participants from the MSM population were recruited for this study, with 10 assuming the insertive role (i.e., "1"), 8 assuming the receptive role (i.e., "0"), and 8 being versatile (i.e., "0.5"). Each participant completed the crossover trial comprising two phases. The cumulative usage of FCs and male condoms (MCs) amounted to 115 and 127 times, respectively. During the reported sexual encounters, no participants reported incidents of condom rupture, slippage, or other malfunctions. A few participants reported experiencing slight chafing pain, primarily put forward by "0" participants. Apart from those reports, no instances of bleeding, swelling, or allergic reactions were reported. The efficiency of FC in disease prevention, the sexual partner's willingness to use FC, the freshness of FC, and positive sexual experiences were the main reasons for the consistent use of FC for anal sex. Discomfort and pain during sexual activity, the loose design and thick material of FCs, and difficulties in placing FCs were the major obstacles to FC use among MSM. The elements referring to the forehead exhibited varied in importance among "1,", "0," and "0.5" participants. Regarding the willingness to use the FC in the future anal intercourse, 61.54% of participants expressed a positive inclination, 23.08% were uncertain, and 15.38% stated that they would not. "A better sense of security during anal sex" was the main factor affecting willingness among "0" participants and "the sexual pleasure that the FC brought" among "1" participants. Improving the design and technology of FCs and increasing the frequency of use and practice might improve the use skills, which will favor the willingness to use FCs among the MSM population. Conclusion FCs received positive user feedback from study participants, but distinctions were found in individuals in different sexual roles. Large-scale quantitative studies are needed to evaluate the clinical safety of the FC and its effectiveness in preventing the transmission of STDs during anal intercourse.
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Affiliation(s)
- Jia-Lu Huang
- School of Public Health, Dali University, Dali, China
| | - Xin Xin
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Pudong New Area Center for Disease Control and Prevention, Shanghai, China
- Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China
| | - Ming-Jun Ma
- School of Public Health, Dali University, Dali, China
| | - Zhen Ning
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Shao-tan Xiao
- Pudong New Area Center for Disease Control and Prevention, Shanghai, China
- Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China
| | - Pan-pan Chen
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Pudong New Area Center for Disease Control and Prevention, Shanghai, China
- Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China
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Barriers and Facilitators to Acceptability of the Female Condom in Low- and Middle-Income Countries: A Systematic Review. Ann Glob Health 2022; 88:20. [PMID: 35433283 PMCID: PMC8916053 DOI: 10.5334/aogh.3612] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Wu J, Zhang J, Li Y, Yang J, Zhou Y, Li Y, Xu S, Zhao R. Short-term acceptability of the Woman's Condom and influencing factors among internal migrants in China. BMC Public Health 2019; 19:1410. [PMID: 31664963 PMCID: PMC6819489 DOI: 10.1186/s12889-019-7625-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 09/13/2019] [Indexed: 11/17/2022] Open
Abstract
Background The Woman’s Condom, a newly designed condom for women, has obtained market approval in China, but it remains relatively unfamiliar to the migrant population. The aim of this study is to evaluate the short-term acceptability of the Woman’s Condom and influencing factors among internal migrants. Methods A longitudinal study was conducted among 1800 migrants in Beijing, Chongqing, and Shanghai in China between August 2013 and August 2014.Three-level model was implemented with the Statistical Analysis System software (v.9.4 SAS Institute) to analyze within-individual changes, between-individuals effects, and between-group effects. Results Three-level model analysis revealed statistically higher short-term acceptability of the Woman’s Condom among subjects who lived in Shanghai (β = 6.50, t = 2.76, p < 0.01), unmarried and not in a cohabiting relationship (β = 3.05, t = 2.76, p < 0.01) than those who lived in Beijing, married and in a cohabiting relationship. Female (β = − 1.69, t = − 7.55, p < 0.01) and lower educational attainment (β = − 2.30, t = − 1.94, p = 0.05) were negatively related, while occupations of education, health, and civil staff (β = 1.50, t = 2.92, p < 0.01) were positively related to acceptability. It was predicted that migrants’ acceptability of the Woman’s Condom would significantly increase over time (β = 1.09, t = 5.54, p < 0.01). Conclusions The findings indicate that the Woman’s Condom enjoyed relatively high short-term acceptability among migrants in China. In order to popularize the Women’s Condoms in migrants, more publicity, consultation and training in open and prosperous areas should be strengthened.
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Affiliation(s)
- Junqing Wu
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Room 307, 779 old Humin Road, Xuhui District, Shanghai, 200032, People's Republic of China.
| | - Junguo Zhang
- Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial Central Hospital, Guangzhou, Guangdong, 510000, People's Republic of China.,NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Medical School, Fudan University, Shanghai, 200032, People's Republic of China
| | - Yuyan Li
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Room 307, 779 old Humin Road, Xuhui District, Shanghai, 200032, People's Republic of China.
| | - Jinming Yang
- Department of Pharmacology, Vanderbilt University School of Medicine, 432 Preston Research Building, 23rd Avenue South at Pierce, Nashville, TN, 37232-6600, USA
| | - Ying Zhou
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Room 307, 779 old Humin Road, Xuhui District, Shanghai, 200032, People's Republic of China
| | - Yiran Li
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Room 307, 779 old Humin Road, Xuhui District, Shanghai, 200032, People's Republic of China
| | - Shuangfei Xu
- School of Public Health, Fudan University, Shanghai, 200032, People's Republic of China
| | - Rui Zhao
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Room 307, 779 old Humin Road, Xuhui District, Shanghai, 200032, People's Republic of China.
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Chen BA, Blithe DL, Muraguri GR, Lance AA, Carr BR, Jensen JT, Kimble TD, Murthy AS, Schreiber CA, Thomas MA, Walsh TL, Westhoff C, Burke AE. Acceptability of the Woman's Condom in a phase III multicenter open-label study. Contraception 2019; 99:357-362. [PMID: 30849305 DOI: 10.1016/j.contraception.2019.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 02/15/2019] [Accepted: 02/18/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aimed to evaluate the acceptability of the Woman's Condom (WC) over 6 months (183 days) and ≥6 menstrual cycles in a US-based multicenter open-label phase III contraceptive efficacy trial. STUDY DESIGN We assessed acceptability via written questionnaire at visit 2 (after the third cycle) and visit 3 (after the sixth cycle or >183 days, or upon early discontinuation). Key domains included ease of use, comfort/lubrication, sexual satisfaction, male partner satisfaction and confidence in pregnancy and sexually transmitted infection (STI) prevention. We analyzed quantitative data using descriptive statistics. We conducted a content analysis to identify major themes from four open-ended questions. RESULTS Most women [327/405 (81%)] had limited or no previous experience with female (internal) condoms. Of 405 evaluable women, 346 women completed questionnaires at visit 2 and 303 women at visit 3; 282 women attended both visits. Of women attending both visits, 165/282 (59%) reported at visit 2 that WC insertion was easy/very easy; this increased to 195/282 (69%) at visit 3 (p=.03). Many women [166/281 (59%)] preferred the WC [105/281 (37%)] or were neutral [61/281 (22%)], while 115/281 (41%) preferred male condoms. Women attending visit 3 felt confident that the WC could prevent pregnancy [246/303 (81%)] and STIs [217/303 (72%)]. Many women expressed empowerment with having control over their contraception; some disliked the design, esthetics and insertion process. Most women (254/299 (85%)] would recommend the WC to a friend. CONCLUSION The WC's acceptability and ease of use is promising for wider dissemination as a female-controlled method that can protect against both pregnancy and STIs. IMPLICATIONS The WC's overall acceptability and ease of use is promising for a new female-controlled barrier contraceptive option that can protect against both pregnancy and sexually transmitted infections.
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Affiliation(s)
- Beatrice A Chen
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA, USA; Magee-Womens Research Institute, 204 Craft Avenue, Pittsburgh, PA, USA.
| | - Diana L Blithe
- Contraceptive Development Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, 6710B Rockledge Dr, Bethesda, MD 20817, USA
| | | | - Audrey A Lance
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA, USA; Northland Family Planning, 35000 Ford Road, Westland MI 48185, USA
| | - Bruce R Carr
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Jeffrey T Jensen
- Department of Obstetrics & Gynecology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | - Thomas D Kimble
- Department of Obstetrics and Gynecology, Eastern Virginia Medical School, 601 Colley Ave, Norfolk, VA 23323, USA
| | - Amitasrigowri S Murthy
- Department of Obstetrics and Gynecology, NYU School of Medicine, Bellevue Hospital Center, 462 First Ave, New York, NY 10016, USA
| | - Courtney A Schreiber
- Department of Obstetrics and Gynecology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Michael A Thomas
- Department of Obstetrics & Gynecology, University of Cincinnati Medical Center, 234 Goodman St, Cincinnati, OH 45219, USA
| | - Terri L Walsh
- Essential Access Health, 3600 Wilshire Blvd, Suite 600, Los Angeles, CA 90010, USA
| | - Carolyn Westhoff
- Department of Obstetrics & Gynecology, Columbia University, 622 West 168th St, PH 16, New York, NY 10032, USA
| | - Anne E Burke
- Department of Gynecology & Obstetrics, Johns Hopkins University, 4940 Eastern Ave, Baltimore, MD 21224, USA
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RamaRao S, Obare F, Ishaku S, Mané B, Clark H, Liambila W, Unumeri G, Birungi H, Diop N, Rajamani D, Townsend J. Do Women Find the Progesterone Vaginal Ring Acceptable? Findings from Kenya, Nigeria, and Senegal. Stud Fam Plann 2018; 49:71-86. [DOI: 10.1111/sifp.12046] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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