Pleasure and prevention: African women's voices on microbicide gel use.
Background: Research suggests that promoting pleasure alongside safer sex messages can facilitate consistent male and female condom use. It has also been argued that ignoring pleasure in sexual health messages can impinge on women's negotiation of safer sex. Efforts have thus been undertaken retrospectively to imbue existing barrier methods with pleasurable and erotic associations. We looked prospectively at women's first-hand reports of sexual pleasure relating to product use in a Phase III vaginal microbicide trial, with a view to understanding facilitators to future use. Methodololgy: In-depth interviews were conducted with a random sub-sample of women participating in the MDP301 Phase III microbicide trial. This preliminary analysis uses data from 464 women at six MDP301 sites in South Africa, Zambia, Tanzania and Uganda. Women's experiences of sexual pleasure in the context of gel use were explored and, specifically, they were asked whether the gel had any effect in increasing or decreasing their enjoyment of sex. Data were coded thematically for sexual enjoyment and a further detailed analysis was then carried out according to the principles of constant comparison. Results: The overwhelming response to gel use was that it increases sexual pleasure. A common theme across sites was that gel increased sexual arousal in both partners, through hastening, intensifying and prolonging the desire for sex. Idioms of pleasure varied cross-culturally; in South Africa, the predominant expression of pleasure was through “hot” sex; in Zambia, Tanzania and Uganda through increased “appetite” and “sweetness”. Increased sexual enjoyment was also located in the reduction of pain and abrasion due to gel lubrication and the sense of health and wellbeing associated with using a study product. Conclusions: Focusing on disease has hindered uptake of prevention methods in the past. Pleasure should now be a key focus in the marketing and promotion of microbicides.
Montgomery, C.M. Pleasure and prevention: African women’s voices on microbicide gel use. Presented at Microbicides 2008, New Delhi, India, 24-27 February 2008. (2008)