ABSTRACT

Whitehead, Sara J., Peter H. Kilmarx, Kelly Blanchard, Chomnad Manopaiboon, Supaporn Chaikummao, Barbara Friedland, Jullapong Achalapong, Mayuree Wankrairoj, Philip Mock, Sombat Thanprasertsuk, and Jordan W. Tappero. 2006. "Acceptability of Carraguard vaginal gel use among Thai couples," AIDS 20(17): 2141–2148.

Objectives
To evaluate the acceptability of candidate microbicide Carraguard® among couples participating in a safety trial.

Study design
A six-month randomized, placebo-controlled trial was conducted in sexually active, low-risk couples in Thailand.

Methods
Couples who were monogamous, HIV uninfected, and not regular condom users were enrolled. Acceptability data were collected through structured questionnaires at repeated intervals. At the closing study visit, participants were asked questions about hypothetical product characteristics and future use. Compliance with gel use was assessed by questionnaires, coital diaries, and tracking of used and unused applicators.

Results
Among 55 enrolled couples, follow up and adherence with gel use were high and sustained, with 80 percent of women using gel in over 95 percent of vaginal sex acts. Because acceptability results from Carraguard and placebo arms were similar, they were combined for this analysis. Overall, 92 percent of women and 83 percent of men liked the gel somewhat or very much; 66 percent of women and 72 percent of men reported increased sexual pleasure with gel use; and 55 percent of women and 62 percent of men reported increased frequency of intercourse. Only 15 percent of women but 43 percent of men thought that gel could be used without the man knowing. Although men and women had similar views overall, concordance within couples was low, with no kappa coefficients above 0.31.

Conclusion
Carraguard gel use was acceptable to low-risk couples in northern Thailand. Reported associations between gel use and increased sexual pleasure and frequency suggest a potential to market microbicide products for both disease prevention and enhancement of pleasure.

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