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Ekong, Ernest*
Akinlade, O**; Idehen, C*; Igbu, T***; Sobowale, Y*; Uwah, A****
* Department of Medicine, Nigerian Army Reference Hospital, Yabaa, Lagos, Nigeria. ** Nigerian Medical Association, Luth Library, Surulere, Lagos, Nigeria: *** World Health Organization, Yenogoa, Bayelsa, Nigeria; **** Public Health Laboratory, Yaba Bus Stop, Yaba, Lagos, Nigeria.
Background:
There is widespread interest and hope in a safe and effective microbicide as a potential way of prevention of transmission of sexually transmitted diseases and HIV/AIDS.
Objective:
To evaluate the knowledge of, and acceptability of microbicides by female commercial sex workers in Lagos, and to assess their willingness to participate in trials involving microbicides
Methods:
Data was derived from a multicentric cohort of female commercial sex workers, through focus group discussions, individual interviews, and use of structured questionnaires covering socio-demographic data including age, religion, marital status, parity, education, and primary occupation. Sexual health and vaginal practices, HIV/STDs status and knowledge, types of microbicides known/used, reasons for use and specific beliefs, as well as readiness or willingness to participate in any trial were evaluated.
Results:
Total numbers of 851 females, mean age 24+ 11years, 28% married, 32% were graduates, 45% high school certificates, while 23% had primary education. On knowledge of microbicides, products identified include foaming tablets, gels, antiseptics, antifungal creams and ointments, antibiotic powders, douches, vaginal tablets, petroleum jelly, alum, and tradomedical preparations. Knowledge and use of foaming tablets, gel, antifungal and antibiotic powders were proportional to level of education. Reasons for use include healthy state of the vaginal (65%), personal sexual pleasure (45%), sexual pleasures for male clients (52%), to prevent contact of infection (62%), keep the virginal tight (45%), and for contraception (45%). Generally where substances were used, men or clients were not made aware. Most preferred products that disintegrated without much wetness in the vaginal, and not coloured. On vaginal practices, 35% reported regularly cleansing the vagina just before sex, while 26% used routinely, antifungal creams like Canesten, Gynostatin also believe to have antibacterial effects. Non-acceptability was due to physical discomforts such as itchiness in the vagina, dysuria, vaginal ulcerations, and excessive wetness by some vaginal pessaries. Some respondents still use alum and some trado-medical preparations for tightening of the vagina. On willingness to participate in microbicides studies, 57% were ready provided they are not long terms studies. Single young respondents were more ready to participate than married.
Conclusion:
There is increased knowledge by commercial sex workers in Lagos about microbicides. Since they constitute a risk group, they need protection. However, there is much concern about cost, availability, safety, effectiveness and comfort in use.
Dr. Ernest Ekong
14 Reeve Road, Flat E17, Ikoyi, Lagos, Nigeria.
(Telephone) 234-1-267-2374 (Fax) 234-1-267-2374 (E-mail) eekong@beta.linkserve.com
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