• Elizabeth T Montgomery, Helen Cheng, Ariane van der Straten, Agnes C Chidanyika, Naomi Lince, Kelly Blanchard, Gita Ramjee, Busisiwe Nkala, Nancy S Padian, and MIRA team.
• Women's Global Health Imperative, RTI International, San Francisco Project Office, 114 Sansome Street, Suite 500, San Francisco, CA 94104, USA. emontgomery@rti.org
• AIDS Behav. 2010 Jun 1; 14 (3): 629-38.

AbstractThe acceptability and use of the diaphragm and lubricant gel were assessed as part of a large randomized controlled trial to determine the effectiveness of the methods in women's HIV acquisition. 2,452 intervention-arm women were enrolled at five Southern African clinics and followed quarterly for 12-24 months. Acceptability and use data were collected by face-to-face interviews at Month 3 and Exit. Participants were "very comfortable" with the physical mechanics of diaphragm use throughout the trial, and approval of the gel consistency, quantity and the applicator was high. At Exit, consistent disclosure of use (AOR 1.97, 95% CI: 1.10-3.55); an overall high diaphragm rating (AOR 1.84, 95% CI: 1.45-2.34) and perception of partner approval (AOR 1.75, 95% CI: 1.35-2.26) were the most significant acceptability factors independently associated with consistent use. Despite being female-initiated, disclosure of use to male partners and his perceived approval of the products were factors significantly associated with their consistent use.

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