A comparison of acceptability of contraceptive vaginal rings, pills, and injectables among cisgender women in Kenya and Zimbabwe: Protocol for a mixed-methods study
Document Type
Article (peer-reviewed)
Publication Date
3-3-2025
Abstract
Expanding contraceptive options could better meet users’ diverse needs and preferences. Annovera ® is a contraceptive vaginal ring that provides a year of pregnancy prevention while remaining under user control and allowing for regular menstrual cycles. This method may also help to reduce burdens on some health care and supply chain systems. However, knowledge gaps exist regarding initial and ongoing acceptability of contraceptive vaginal rings in African settings.
We will undertake an open-label, non-randomized, two-arm, parallel clinical acceptability study with an embedded qualitative component, based in clinics providing contraceptive services in Kenya and Zimbabwe. Women aged 18-45 interested in newly initiating or switching contraception will choose from among all available contraceptive options, including Annovera. We aim to enroll 200 participants selecting Annovera and 200 participants selecting either contraceptive injectables or pills. We will compare method uptake, continuation, and satisfaction over one year. Participants will complete questionnaires administered by study staff during two in-person visits (a screening/enrollment visit, and an end of study visit after 52 weeks of method use or at discontinuation) and four phone appointments (at 4, 12, 24, and 36 weeks of use). We will evaluate used rings for discoloration and residual drug levels. The qualitative component involve in-depth interviews with women in the clinical study, their sexual partners, and their service providers, to further examine drivers of and barriers to interest in and use of contraceptive vaginal rings.
This study will explore acceptability of contraceptive vaginal rings in ‘real-world’ contraceptive service settings in two African countries. Findings will be based on actual ring use and contextualized via comparison to two other commonly available methods. As vaginal rings are being considered for multiple reproductive health indications, this work can fill key knowledge gaps and empower decision-makers with information needed to inform future investments in reproductive health.
Recommended Citation
Polis, Chelsea B., Francis O. Obare, Irene V. Bruce, Cynthia Banda, Lisa B. Haddad, Antwanette Heyns, Petros Isaakidis, Mercy Kamupira, Terrance Kufakunesu, Zachary A. Kwena, Farai Machinga, Regina F. Magore, Aleck Mapangire, Mercy Marimirofa, Matheus Mathipa, Sanyukta Mathur, Mary Mudavanhu, Tatenda P. Mujuru, Prisca Mutero, Betty Njoroge, Collen Nyatsambo, Sarah Okumu, Leah Omondi, Tevyne Omondi, Marlena Gehret Plagianos, Greshon Rota, Samuel Sithole, Bruce Variano, J. Brady Burnett-Zieman, Petina Musara, George Odwe, Gerald Hangaika, Serah Gitome, Elizabeth A. Bukusi, and Kuziwa Kuwenyi. 2025. "A comparison of acceptability of contraceptive vaginal rings, pills, and injectables among cisgender women in Kenya and Zimbabwe: Protocol for a mixed-methods study," Gates Open Research 2025, 9:5.
DOI
10.12688/gatesopenres.16315.1
Language
English
