Predictors of Diaphragm Use as a Potential Sexually Transmitted Disease/HIV Prevention Method in Zimbabwe

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Abstract
Women who are the most vulnerable to sexually transmitted diseases/HIV are often unable to consistently use condoms. One potential alternative method currently under investigation is the diaphragm. The goals of this study were to assess diaphragm uptake and use over time in Zimbabwe and to identify factors associated with self-reported consistent diaphragm use. Women attending family planning clinics who were inconsistent condom users received a diaphragm intervention and were followed for 6 months. Of the 186 participants, 99% ever reported using the diaphragm, and, at study exit, 96% had used it in the previous 2 months. Consistent diaphragm use since the previous visit was reported by 13% to 16% of the women, and in multivariate regression analysis, it was significantly associated with never using condoms (adjusted odds ratio, 24.08; 95% confidence interval, 6.71–86.34). Other factors included discreet use, preferring diaphragms to condoms, timing of insertion, domestic violence, and contraception. Diaphragms were well accepted among women at risk for sexually transmitted diseases/HIV.