LONG TERM ACCEPTABILITY OF HIV PREVENTION METHODS

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In this application, we propose a 12-month longitudinal follow-up of two cohorts of women who have completed a parent study and their main sex partners. The parent study is a randomized control trial in which we are evaluating a framework for present women with multiple prevention options and assessing acceptability of these methods over a three month period. In the parent study, Cohort 1 will have receive a multiple option intervention (MO) in which 3 prevention methods (male condoms, female condom, Advantage S) were presented in a hierarchical order of safety and Cohort 2 will have received a single option condition focused on male condoms. The current application builds on the parent study by: 1) examining acceptability of methods longitudinally; 2) conducting structured assessments with women's main sex partners; 3) using a relational perspective to explore how individual, relationship, and socio- cultural factors influence acceptability for both women and their partners; and 4) conducting qualitative interviews to explore the complex relationship and socio-cultural processes that influence acceptability. Cohort 1 women will be assessed at 6 and at 12 months post MO intervention and their main sex partners will be interviewed at 3 time points to corresponds to the women's 3, 6, and 12 month assessments. To equalize exposure to the multiple options across the two cohorts, Cohort 2 will be offered the multiple option intervention. Cohort 2 women and their partners will be assessed at baseline, and at 3, 6, and 12 months post intervention. Multi-variate growth cure analyses will be applied to the longitudinal data. The goal of the qualitative interviews is to gain insight into the complex relationship and socio-cultural processes that influence acceptability of different prevention options. Two sub-samples will be purposively selected. The first sample will include only women have been in a stable relationship of 3 or more months and who meet one of the following criteria: 1) adopted male or female condoms; 2) only use Advantage S; or 3) do not use any method at all. The second purposive sample will include women who are in new relationships (a relationship of three months or less). The qualitative analysis of the interviews will allow us to extend our knowledge of static risk and protective factors that affect sexual risk behavior and use of prevention methods to more complex processes. Understanding of risk and protective processes can guide the development of interventions to improve acceptability.