Men’s Attitudes Toward Vaginal Microbicides And Microbicide Trials in Zimbabwe

preceding the DHS survey, as did 0.2% of married women. In addition, 7% of men reported that they had paid for sex during the same time period. It seems unlikely that in the near future levels of male condom use, abstinence or adherence to mutually faithful relationships will increase so significantly in Zimbabwe that the HIV epidemic will be slowed or stopped.3 Given the previous success of female-controlled methods of contraception such as oral contraceptives and injectables in Zimbabwe,* female-controlled methods of HIV and sexually transmitted disease (STD) prevention may be more successful than male-controlled methods. Such methods may include vaginal microbicides, which could be applied directly inside the vagina in the form of a gel, film, sponge, foaming tablet or suppository. A safe vaginal microbicide that effectively protects women from HIV is not currently available. Clinical trials have demonstrated that commercially available spermicides containing nonoxynol-9 can reduce the risk of both gonorrhea and chlamydial infection,4 but the evidence regarding their effectiveness against HIV is inconclusive.5 Janneke H.H.M. van de Wijgert is programme director at the University of Zimbabwe–University of California at San Francisco (UZ–UCSF) Collaborative Research Programme in Women’s Health, Harare, Zimbabwe, and researcher in the Department of Obstetrics, Gynecology and Reproductive Science, University of California at San Francisco, CA, USA. Gertrude N. Khumalo-Sakutukwa is programme social scientist, Sabada E. Dube is research assistant and Prisca Nyamapfeni and Magdalene Mwale are research nurses, all at the UZ–UCSF Collaborative Research Programme in Women’s Health, Harare, Zimbabwe. Christiana Coggins was staff associate at the Population Council, New York, at the time of the study, and Nancy S. Padian is associate professor in the Department of Obstetrics, Gynecology and Reproductive Science, University of California at San Francisco, CA, USA. The authors would like to acknowledge Michael Chirenje, Martha Moon, Tinos Kucherera, Maria Iyog O’Malley, Judith Heiman and the owners of the two farms and the taxi company for their contributions to the projects described in this article. Partial support for the focus-group discussions with the farm workers and taxi drivers was provided by the U. S. Agency for International Development, Office of Health. Support for the pretrial focusgroup discussion was received from the National Institute of Allergy and Infectious Diseases, Division of AIDS, Vaccine and Prevention Research Program, which is administered by Family Health International. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the donor agencies. Men’s Attitudes Toward Vaginal Microbicides And Microbicide Trials in Zimbabwe