MICROBICIDES: DEVELOPMENTAL CONTEXT OF ACCEPTABILITY

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DESCRIPTION (Adapted from the applicant's description): Sexually transmitted diseases (STDs) are a major health problem for adolescents. The development of new methods for STD prevention such as topical microbicides is of high priority. To be effective, microbicides will need to be accepted and used. Adolescent-specific interventions will be needed to promote microbicide use among adolescents. The current proposal examines developmental factors that are associated with use of microbicide-like formulations among adolescent girls and explores the attitudes of significant individuals (boys, mothers, health care providers) who impact adolescent girls' decision-making. Specific Aims: 1) To describe how adolescent females and males and significant adults (mothers of adolescent girls and health care providers) anticipate using a topical microbicide. The applicant will address research questions focused on their familiarity with the products, aspects that foster use, barriers to use, and how these perceptions vary across different groups. 2) To evaluate how discussion of use, initial use, and sustained use varies as a function of developmental characteristics (cognitive functioning and decision-making, psychosexual maturation, sociocultural context), and the experience with the product. Methods: The first specific aim will be accomplished by conducting focus groups of adolescent males, adolescent females, mothers, and health care providers. The second specific aim and relevant hypotheses will be tested by recruiting 200 adolescent girls (14 to 21 years) to participate in a study during which they have an opportunity to use approved intravaginal contraceptive products. These girls will be followed weekly for six months to determine use of the product and their experiences using or not using the product. Significance: This work will provide important new information regarding factors that will influence microbicide use by adolescent girls. The results of our research will be critical in guiding the development of adolescent-specific interventions that will foster the acceptability and use of microbicides, and in doing so, will result in better control of STDs among adolescents.