The background MDP 301 trial is a phase III trial of an anti-HIV vaginal microbicide. High pregnancy rates continue to pose a challenge to microbicide trials, resulting in decreased microbicide exposure follow-up data and negatively impacting on the power of the study. Mandatory contraception use is not an inclusion criterion but women are counseled and contraception at the trial sites is promoted. Many women were not on contraceptives at the time of screening; we explored the reasons for this. OBJECTIVES: To determine the common myths/misconceptions regarding non-use of contraceptives. METHODOLOGY: Sexual behavior interviews at enrolment were analyzed to determine the number of women not on contraception and the reasons for this. Intensive counseling was done to correct the misconceptions and explain the side effects of hormonal contraceptives. Sexual behavior interviews were then analyzed at follow-up to determine how many women took up contraception. RESULTS: Of the 1552 participants enrolled by the end of August 2007, 95 (6%) reported the following reasons for not using contraception: Hormonal contraceptives cause obesity, and water retention; retained water leads to excessive lubrication during sexual intercourse, which is not appealing to their male partners as it is regarded as a sign of promiscuity and decreases sexual pleasure; hormonal contraceptives lead to absence of menstruation, meaning that the blood goes to the brain and causes persistent headaches and nosebleeds; they can interfere with a man's sexual functioning, also leading to impotence; women on contraception are loose, as they fear not knowing who fathered the baby; hormonal contraceptives lead to infertility when taken before a person starts a family. Of these 95 women, 60 (63%) were successfully counseled into taking up hormonal contraceptives. CONCLUSIONS: Many myths and misconceptions regarding side effects of contraceptives exist. With additional targeted counseling and education, these misconceptions can be corrected resulting in an increase in uptake of effective contraception.
Mshibe, L.C. Impact of myths and misconceptions of contraceptive practices in MDP participants, Durban. Presented at Microbicides 2008, New Delhi, India, 24-27 February 2008. (2008)