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27.04.2019 | Original Paper

Hygiene, Blood Flow, and Vaginal Overload: Why Women Removed an HIV Prevention Vaginal Ring During Menstruation in Malawi, South Africa, Uganda and Zimbabwe

AIDS and Behavior
Zoe Duby, Ariana W. K. Katz, Erica N. Browne, Prisca Mutero, Juliane Etima, Chifundo Colleta Zimba, Kubashni Woeber, Millicent Atujuna, Krishnaveni Reddy, Ariane van der Straten, the MTN-020/ASPIRE Study Team
Wichtige Hinweise
The members of the MTN-020/ASPIRE Study Team are listed in the acknowledgments.

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We assessed the interference between vaginal ring use and menses among women who participated in the qualitative component of the MTN-020/ASPIRE vaginal ring trial in Malawi, South Africa, Uganda and Zimbabwe (N = 214). A common reason for imperfect ring adherence and premature removal of the vaginal ring cited by participants related to vaginal bleeding or menses. Whereas self-reporting via survey questions suggested that the majority (60%) of women did not mind wearing the ring while menstruating, and did not remove it (91%) during menses, in the qualitative interviews women frequently described removing the ring during menses. Their reasons included hygiene, beliefs that the ring blocked the flow of menstrual blood, fears that the ring would come out with blood or during tampon removal, and concerns around an ‘overburdened’ vagina. Examining women’s narratives and subjective experiences related to menstruation helps build a better understanding of factors affecting ring use and adherence.

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