Abstract

In the Microbicides Development Programme trial of a candidate vaginal microbicide gel involving 9385 women in six African settings, data on sexual behaviour and gel use were collected from a random subsample of 725 participants through 1866 in-depth interviews, coital diaries and questionnaires, 462 interviews with male partners, and 100 focus groups.

Although vaginal microbicides were conceived as a “female controlled” method of protection that women could use covertly when unable to negotiate condom use, most women informed their partners in practice.

Almost half the women (and a similar proportion of male partners) reported that the gel increased sexual enjoyment, mainly due to lubrication. This was also the case in areas where “dry sex” is practiced. Increased sexual pleasure (and to some extent the use of the product per se) enhanced communication and intimacy in the relationships. Women utilized this to negotiate condom use with reluctant partners. Condom use and male acceptance of condoms increased during the trial. Although this was partly due to the trial context, the positive effect of gel use on relationships and condom use was clear.

The data suggest that the widespread distribution of vaginal lubricants could lead to better and safer sex.