Social Context of Adherence in an Open-Label 1 % Tenofovir Gel Trial: Gender Dynamics and Disclosure in KwaZulu-Natal, South Africa

May 2016 - Structural Prevention

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MacQueen, K.M., Dlamini, S., Perry, B., et al. AIDS and Behavior (March 2016), e-publication ahead of print.

CAPRISA 106, an ancillary study of the Centre for the AIDS Programme of Research in South Africa (CAPRISA 008) trial, assessed the acceptability of tenofovir gel among women and men; the influence of gender dynamics on tenofovir gel use disclosure; and social barriers and facilitators of tenofovir gel use. The authors conducted interviews with 63 CAPRISA 008 participants and 13 male partners in rural and urban KwaZulu-Natal. For women, disclosure of tenofovir gel use was determined by relationship dynamics, including the duration of the relationship, the living situation, and an evaluation of the relationship (e.g., partner intimacy and expectations about the relationship). Whether or not they disclosed, women reported using the gel effectively; in some situations, disclosure was itself a barrier to adherence. Women were least likely to disclose to their partners that the gel's active ingredient is tenofovir, which is an antiretroviral (ARV), because of the prevalent understanding of ARVs as treatment for HIV infection and the social stigma surrounding HIV. The authors concluded that women should be supported in their choice about what to disclose to their partners, and should have opportunities to use tenofovir gel and similar products without their partners’ knowledge.

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