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Background: Topical microbicides (TMs) could be an option for the prevention of STIs and bacterial vaginosis (BV) among pregnant women since motivation for condom use is poor. Little is known about how TM use might affect sexual behaviors during pregnancy.
Methods: 26 women in their third trimester (mean age=24.9), recruited from a clinic serving inner-city minorities, participated in a qualitative study on TM acceptability and use for prevention and treatment of BV. Via individual interviews, participants discussed general changes in their sexual behaviors throughout pregnancy as well as their views on the potential impact of TM use on sex during the third trimester. Interviews were coded for relevant themes around sexual behavior.
Results: Most women described a decrease in sex frequency (n = 19) during pregnancy for reasons including decreased desire, fatigue, discomfort, and partner’s concerns about harming the baby. There was discussion of non-penetrative intimacy. Participants reported partners as being understanding about decreased frequency of sex, but some perceived that partners were no longer attracted to them. When asked how using TMs for prevention during the last trimester would affect sex, responses were variable and included decreased sex (due to messiness/leakage, interference with medication, concern for effects on partner), no impact, increase, and attempting to use the TM without decreasing sex. Regarding use for treatment, most respondents said they would decrease sex and indicated prioritization of treating an active infection.
Conclusions: The women in this study report an overall decrease in frequency of sex during pregnancy as well as a projected further decrease if treating an infection with TMs. As TM products are developed and studied, it is important to include pregnant women in these studies and to be able to understand and counsel around effects of TM use on sexual behavior.