Ibis Reproductive Health

MIRA Social Science Study

The MIRA Social Science Study was conducted concurrently with the MIRA trial at the three trial sites: the Medical Research Council in Durban, South Africa; the Perinatal HIV Research Unit in Johannesburg, South Africa; and the University of Zimbabwe-University of California, San Francisco Collaborative Research Programme in Women’s Health in Harare, Zimbabwe. The objectives of the study were to use qualitative research methods to:

Study the experiences of trial participants, including the following: understanding and acceptability of the concepts and process of informed consent; acceptability of and compliance with the trial procedures; issues of stigma; and social and community factors that may have affected conduct during the trial.
Assess the acceptability and feasibility of the diaphragm and lubricant gel as a sustainable HIV prevention strategy by examining: a) individual attitudes toward and practices of diaphragm and gel use, including issues of stigma related to their use; b) partner attitudes toward the diaphragm and gel and partners’ involvement in and awareness of decision-making about the actual use of the products.

To investigate the experiences of women who participated in the MIRA trial, we completed 19 focus group discussions with 144 women participants between October 2005 and June 2006. In addition, the two South Africa sites completed 54 semi-structured interviews with women who were screened out of the trial to understand their perceptions of the trial and reasons for attempting to participate in it. To examine acceptability and feasibility of the diaphragm, gel, and condoms, we completed 27 focus group discussions between August 2006 and March 2007 with 215 women from both the intervention arm and the control arm (condoms only) of the trial, as well as seven focus group discussions and ten in-depth interviews with 41 male partners of women in the intervention arm.

The MIRA Social Science Study generated extensive qualitative data on women’s trial experiences, their perceptions of and experiences with using the diaphragm and gel, and the contexts of these experiences. These data will provide insights into power and negotiation within women’s sexual relationships; understanding these dynamics is vital to the development and introduction of new methods of HIV prevention that women can and will use.

Throughout 2008, the MIRA team will be analyzing the data and writing manuscripts that probe these themes further. MIRA Social Science staff have presented poster presentations of data from the Social Science Study at the XVI International AIDS Conference in Toronto, Canada, in August 2006; the 3rd South African AIDS Conference in Durban, South Africa, in June 2007; and the Microbicides 2008 Conference in New Delhi, India, in February 2008. The team will also present at the upcoming XVII International AIDS Conference in Mexico City in August 2008.

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