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首页> 外文期刊>AIDS care. >The role of partnership dynamics in determining the acceptability of condoms and microbicides.
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The role of partnership dynamics in determining the acceptability of condoms and microbicides.

机译：伙伴关系动力学在确定避孕套和杀菌剂的可接受性中的作用。

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Microbicides are a class of substances under development that could reduce the sexual transmission of HIV and other sexually transmitted diseases when applied locally to genital mucosal surfaces. Microbicide acceptability research has largely focused on product characteristics, rather than processes of negotiation within relationships about use. Gender relations, decision-making power and communication within sexual relationships are recognised as important determinants of condom and contraceptive use, and are likely to determine microbicide use also. As part of social science research linked to the Microbicides Development Programme (MDP) we combine relationship-based theories with anthropological work conducted with women and men using a placebo gel. We explore communication and decision-making in gel and condom use, including constructions of risk and trust. During the MDP301 Phase III pilot study, in-depth interviews were conducted at sites in South Africa, Tanzania, Uganda and Zambia. Following four weeks of placebo gel use, women and their partners were asked about gel use and acceptability, partner involvement, sexual practices and condom use. Data from 45 couples at five sites were analysed using a grounded theory approach in NVivo. Participation in the study did not require women to inform their partners, yet our data shows women seeking permission from their partners, negotiating disclosure, exchanging information and persuading or motivating for gel use. Although gel was supposedly 'woman-controlled', men exercised considerable influence in determining whether and how it was used. Despite this, negotiations around use were largely successful, since the gel increased sexual pleasure and provided opportunities for intimate communication and the building of trust. Decisions about condom and microbicide use are made in a dyadic context and involve a complex negotiation of risk and trust. Whilst preferences relating to product characteristics are largely individual, use itself is dependent on partnership dynamics and the broader social context in which sexual risk management occurs.
机译：杀微生物剂是一类正在开发中的物质，当局部应用于生殖器粘膜表面时，它们可以减少HIV和其他性传播疾病的性传播。杀菌剂可接受性研究主要集中在产品特性上，而不是在使用关系内的谈判过程。性别关系，决策权和性关系中的交流被认为是安全套和避孕药具使用的重要决定因素，并且很可能也决定了杀微生物剂的使用。作为与杀微生物剂发展计划（MDP）相关的社会科学研究的一部分，我们将基于关系的理论与使用安慰剂凝胶对男女进行的人类学工作相结合。我们探索凝胶和安全套使用中的沟通和决策，包括风险和信任的构建。在MDP301第三阶段试点研究期间，在南非，坦桑尼亚，乌干达和赞比亚等地进行了深入采访。在使用安慰剂凝胶四周后，询问妇女及其伴侣关于凝胶的使用和可接受性，伴侣的参与，性行为和避孕套的使用。使用NVivo中的扎实理论方法分析了来自五个地点的45对夫妇的数据。参与该研究并不需要妇女告知其伴侣，但是我们的数据显示，妇女在征得其伴侣的许可，谈判信息披露，交换信息以及说服或鼓励使用凝胶。尽管据说凝胶是“妇女控制的”，但男人在决定是否使用凝胶以及如何使用凝胶方面发挥了相当大的影响。尽管如此，由于凝胶增加了性快感并提供了亲密交流和建立信任的机会，因此围绕使用的谈判在很大程度上取得了成功。有关使用避孕套和杀微生物剂的决定是在二元环境中做出的，涉及风险和信任的复杂谈判。尽管与产品特性相关的偏好在很大程度上是个人的，但使用本身取决于伙伴关系的动态以及发生性风险管理的更广泛的社会环境。

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