High acceptability of a contraceptive vaginal ring among women in Kigali, Rwanda

• Published in: PloS one 2018-06, Vol.13 (6), p.e0199096
• Main Authors: Kestelyn, Evelyne, Van Nuil, Jennifer Ilo, Umulisa, Marie Michelle, Umutoni, Grace, Uwingabire, Alice, Mwambarangwe, Lambert, Uwineza, Mireille, Agaba, Stephen, Crucitti, Tania, van de Wijgert, Janneke, Delvaux, Thérèse
• Format: Article
• Language: English
• Subjects: Acceptability; Acquired immune deficiency syndrome; Adult; AIDS; Biology and Life Sciences; Birth control; Breastfeeding & lactation; Childrens health; Clinical trials; Contraception Behavior; Contraceptive Devices, Female; Data collection; Data processing; Developing Countries; Disease prevention; Engineering and Technology; Family planning; Female; Focus Groups; HIV; Human immunodeficiency virus; Humans; Infections; Interviews as Topic; Lubrication; Maternal & child health; Medicine and Health Sciences; Methods; Norms; Patient Acceptance of Health Care - psychology; People and Places; Physical Sciences; Qualitative analysis; Research and Analysis Methods; Rwanda; Sexuality; Side effects; Social Sciences; Studies; Surveys and Questionnaires; Vagina; Vaginal contraceptives; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0199096

Introduction of contraceptive vaginal rings (CVRs) could expand the contraceptive method mix reducing the unmet need for family planning in Rwanda, but data on acceptability of CVRs from low and middle-income countries are lacking. This study explores acceptability of contraceptive vaginal ring (NuvaRing) use in Kigali, Rwanda using a mixed methods approach. We collected quantitative and qualitative data before, during and after conducting a clinical trial, using Case Report Forms, Interviewer Administered Questionnaires, In Depth Interviews and Focus Group Discussions. We analyzed the data using an existing theoretical framework including product attributes, relationship attributes and sexual encounter attributes as well as the contextual environment. Our data showed that initial worries reduced over time with actual ring use and ring insertions and removals were described as easy. Most women did not feel the ring during daily activities, appreciated the lack of perceived negative side effects and the increased lubrication. Relationship attributes and sexual encounter attributes such as sexual comfort played a significant role in ring acceptability of the participants and their partners. The contextual environment including Rwandan cultural norms around sexuality positively influenced the acceptance of the NuvaRing. Overall satisfaction was high. Acceptability of the Nuvaring was high among study participants and represents a promising option that could contribute to lowering the unmet need for family planning in Rwanda.