Health Practices and Vaginal Microbicide Acceptability among Urban Black Women

Background: Intravaginal topical microbicides are being investigated for prevention of HIV transmission. Useof vaginal microbicides will constitute a new type of practice, occurring in the context of other vaginal practicesrelated to contraception, hygiene, and self-care, which are affected by cultural norms and personal beliefs.Given the high rate of HIV infection among black women, research on practices and decision making relevantto microbicide acceptability is needed in this population. Methods: Twenty-three black women in New York City, aged 25–64, completed in-person semistructured interviewsand self-administered questionnaires. Quantitative analyses examined vaginal practices and willingnessto use microbicides. Qualitative analyses explored underlying decision-making processes involved inchoices regarding vaginal practices and general healthcare. Results: Willingness to use vaginal products for HIV prevention was high, especially among more educatedwomen. Safety was a major concern, and women were cautious about using vaginal products. Whereas someviewed synthetic products as having potentially harmful side effects, others perceived natural products as riskybecause of insufficient testing. Choices about vaginal practices were affected by assessments of risk and efficacy,prior experience, cultural background, and general approach to healthcare. Conclusions: The majority of women in the sample expressed willingness to use a vaginal product for HIV prevention.Decision-making processes regarding vaginal practices were complex and were affected by social, cultural,and personal factors. Although specific preferences may vary, attitudes toward using a vaginal productare likely to be positive when side effects are minimal and the product is considered safe.