Background
Methods
MTN-003/VOICE: Termination visit vaginal or oral product behavioral questionnaire (TVB/TOB) data on motivation to join
MTN-003D/VOICE-D: Participants and procedures
Total (n = 171) | Durban, South Africa (n = 47, 27%) | Harare, Zimbabwe (n = 65, 38%) | Kampala, Uganda (n = 59, 35%) | Difference by CountryϮ | |
---|---|---|---|---|---|
Age | |||||
Median (mean, min-max) | 28 (28.9, 20–41) | 25 (26.8, 20–40) | 29 (29.6, 21–41) | 29 (29.9, 20–41) |
0.0008
|
Married | |||||
Yes | 92 (54%) | 0 (0%) | 57 (88%) | 35 (59%) |
< 0.0001
|
No | 79 (46%) | 47 (100%) | 8 (12%) | 24 (41%) | |
If unmarried (n = 79), has primary sex partner | 68 (86%) | 43 (91%) | 6 (75%) | 19 (79%) | 0.2147 |
Partner has other sexual partners | |||||
Yes | 48 (30%) | 6 (14%) | 12 (19%) | 30 (56%) |
< 0.0001
|
No | 12 (8%) | 3 (7%) | 3 (5%) | 6 (11%) | |
Don’t know | 100 (63%) | 34 (79%) | 48 (76%) | 18 (33%) | |
# of lifetime sex partnersb | |||||
Median (mean, min-max) | 3 (10.8, 1–99+) | 2 (3.4, 1–15) | 1 (2.4, 1–35) | 5 (26.1, 2–99+) |
< 0.0001
|
# of children alive at birth | |||||
Median (mean, min-max) | 2 (2.1, 0–6) | 1 (1.3, 0–4) | 2 (2.3, 1–5) | 2 (2.5, 0–6) |
< 0.0001
|
# of children taking care of | |||||
Median (mean, min-max) | 2 (2.3, 0–6) | 1 (1.5, 0–6) | 3 (2.7, 1–6) | 3 (2.7, 1–5) |
< 0.0001
|
Completed secondary school or more | 68 (40%) | 20 (43%) | 28 (43%) | 55 (93%) |
< 0.0001
|
Earns own income | 125 (73%) | 40 (85%) | 35 (54%) | 50 (85%) |
< 0.0001
|
Method of earning incomea | |||||
Formal employment | 28 (22%) | 9 (23%) | 6 (17%) | 13 (26%) | 0.6616 |
Self-employment | 67 (54%) | 1 (3%) | 29 (83%) | 37 (74%) |
< 0.0001
|
Other | 33 (26%) | 33 (83%) | 0 (0%) | 0 (0%) |
< 0.0001
|
Partner provides financial/material support | 146 (91%) | 36 (84%) | 58 (92%) | 52 (96%) | 0.1036 |
SES Scorec | |||||
Lowest 40% | 68 (40%) | 7 (15%) | 16 (25%) | 45 (76%) |
< 0.0001
|
Middle | 70 (41%) | 18 (38%) | 38 (58%) | 14 (24%) | |
Highest 20% | 33 (19%) | 22 (47%) | 11 (17%) | 0 (0%) |
VOICE-D: Data analysis
Results
Participant characteristics
VOICE-D: Qualitative findings on motivations to participate
Participating for personal health benefits
Repeat HIV testing
What made me stay in the research study was that each time I came, they would test my blood and give me the negative results and I also benefited from the other treatment they offered to me each time I told them the pain I had… (Charity, FGD, Uganda).
I realized that if I did not join VOICE, I would put my life at risk; in that I could contract a disease [HIV/AIDS] unawares because my husband is the kind of person who always has girlfriends [extra-marital affairs]. So, I concluded that if I joined VOICE I would always know my health status…I was also tested for other sexually transmitted diseases. (Kudzai, IDI, Zimbabwe).
I came to the study so that I could be told whether I had the HIV virus. When they tested me and found that I was safe [not HIV infected] I was happy because I was healthy. I went home and told my husband that there was an association/organization [referring to clinic] and that he should also be tested. He didn’t refuse. He came and was also tested and both of us were found to be safe [HIV negative]. (Kijai, IDI, Uganda).
I also heard that we were going to get tested for many things. It’s easy to not use a condom and that’s what also worried me. As young people we sometimes forget to use condoms but being in the research has kept me well. (Khule, IDI, South Africa).
Health care evaluations, treatment and counseling
R: The fact that you get medical check-ups for your health status, ways of family planning, blood check-up, and any other information about your health.I: Uhm [ok]. Did they carry out tests on you?R: Yes.I: What exactly where they checking for?R: HIV/AIDS, Yellow/Liver fever, pregnancy tests and in case you have any sickness, they give you treatment. For example, I came when I had some pain in my fallopian tubes, but I was thoroughly treated. (Afiya, IDI, Uganda).
Yes, and she [staff] explained to me. She told me what is good about it [the research]. Sometimes you don’t get a chance to do a check-up. I didn’t even know what a pap-smear is before…But then I found out. That helped me because they found something wrong with me. (Thabisile, IDI, South Africa).
Personally, I wanted to access that treatment and that is why I remained in the trial in spite of the itching. Because I was well taken care of. The other reason is that I thought I had one of those diseases but God helped me. When I was checked, I was not found with Candida or any other disease. But I also saw those with diseases being treated. I also came so that if I was found with diseases, I would receive treatment. (Diana, FGD, Uganda).
Yes, I was encouraged. I was afraid before but by the time I joined [VOICE] I was more at ease because I had been told that if the results are not good [HIV positive], I will get counselling, they will explain things to me and I won’t have any problem. (Bheka, IDI, South Africa).
Perceived preventative benefits
I always liked to participate in research; on your arrival to participate, your status was being checked [HIV blood test] for your own knowledge. I also liked protecting myself from the virus [prevent HIV acquisition] through the study products we used. (Lesedi, IDI, South Africa).
It was the same but the thought that you got tested, like every month…It calmed me down. But then, the fact that it was a study also. So it’s natural to wonder about whether it works or [laughing] it doesn’t. So I think it was an issue of striving and hoping, I hope it works [laughing]. (Anesu, IDI, Zimbabwe).
Reimbursement and healthcare costs
I: Were you motivated by anything you stood to gain from taking part in the research?R: Money.I: Money? Okay. Is there anything else?R: It was money and wanting to know my status. (Anelisa, IDI, South Africa).
I: Is there any other motivation for your joining the study?R: No…Because when I was coming, I was not told that there was some money…If I had been told, maybe one would say that I came to make some money…No.I: Didn’t your friend tell you about the money?R: She just told me that it was voluntary.I: Mmm.R: She didn’t tell me that there was some money involved. (Sanyu, IDI, Uganda).
Because they used to take off blood and you would know the state of your health. That is what was most attractive to me...In other places, I would have been charged for the tests and I did not have money during that time. (Dembe, IDI, Uganda).
Let me just say I don’t earn a lot of money, so I didn’t have enough money to go for medical check-up, but I could get it [checkup] here [at the study clinic] for free. (Namukasa, IDI, Uganda).
Social networks influence
It was actually a friend of mine that initially brought the program to my attention. I asked her what the program was all about, and she advised me that I should go there and get more information about the program. And if the opportunity arose, I should then join the program. (Uchi, IDI, Zimbabwe).
She [friend] heard about it from someone else who had taken part in the research and she took me there. They accepted us at the research…She must have told her that, ‘if you take part in the research, you can be safe.’ [..] Because they test you most of the time and give you something [product] to protect yourself with. And for real, when I was still participating in the study, I was protected and my life was all right. (Nobuntu, IDI, South Africa).
Joining for altruism
I found it to be good because they said they were trying to find out if there was a drug which was able to protect women from contracting the disease [HIV infection] through sex. So it’s within my rights to join, though I might not enjoy the benefits myself, it might benefit my child or another woman like me. (Mbira, IDI, Zimbabwe).
One of the reasons why I decided to join VOICE was that I could see that women could be helped to prevent becoming infected with HIV, if they use the products provided. I also got a chance to get tested and know my status. I also wanted to know more about what to use so as to prevent myself from falling pregnant. (Nofoto, IDI, South Africa).
Committed to the study and wanted study results
Me, I think that because of the way we had made a contract with MTN [Microbicide Trial Network], it was hard to breach it. You had decided and signed that you would stay until study ends. So you had to finish the study. (Sharon, FGD, Uganda).
What motivated me stay in the study despite not using the products? ... It was just wanting to get to the end of the study. […] Yes, because we had an agreement that when you enter you must, you must finish off. However, if you were disinterested; some just left in the middle of the study if they had lost interest in the study. (Mudiwa, IDI, Zimbabwe).
R: I wanted to see the results of the trial. At the end if it will be a success or not.I: Alright. You wanted to see if the trial was going to be successful or not?R: Ummmh. In addition, I was also gaining a lot of useful knowledge from the trial.I: You were gaining knowledge? What did you struggle most with, related to taking the products?R: I was worried that the product might have significant side effects and I would put my health in danger. (Zendaya, IDI, Zimbabwe).
VOICE: TVB/TOB quantitative findings on motivation to participate
Participated in VOICE-D at VOICE-D Sites | ||
---|---|---|
Yes (n = 106) | No (n = 684) | |
Motivation to join VOICE (multiple answers allowed) | ||
To help test a product that may prevent women from getting HIV | 101 (95%) | 660 (97%) |
To get information about HIV prevention | 92 (88%) | 618 (91%) |
To be tested for HIV | 89 (84%) | 603 (89%) |
For the free or better quality health care during the trial |
72 (69%)*
|
555 (82%)*
|
For the financial reimbursement | 13 (13%) | 73 (11%) |
Other | ||
Yes | 0 (0%) | 2 (< 1%) |
No | 95 (100%) | 640 (100%) |