Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2018 Jun 18;13(6):e0199096.
doi: 10.1371/journal.pone.0199096. eCollection 2018.

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

Evelyne Kestelyn  1   2 , Jennifer Ilo Van Nuil  1   2 , Marie Michelle Umulisa  1 , Grace Umutoni  1 , Alice Uwingabire  1 , Lambert Mwambarangwe  1 , Mireille Uwineza  1 , Stephen Agaba  1 , Tania Crucitti  3 , Janneke van de Wijgert  2 , Thérèse Delvaux  3 ; Ring Plus Study Group
Affiliations
Randomized Controlled Trial

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

Evelyne Kestelyn et al. PLoS One. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of the study process detailing screen failure rates.
The study screen flow is presented detailing screen failure rates.
Fig 2
Fig 2. Flow chart of quantitative and qualitative data collection in the Ring Plus study.
Quantitative and qualitative data collected before, during and after study end are presented.
Fig 3
Fig 3. Theoretical framework used for data collection and analysis as adapted from Van der Straten et al [38] and Merkatz et al [40].
The framework proposed by van der Straten et al [35] was used for data collection and analysis; elements of the NES/EE CVR acceptability model by Merkatz et al [37] such as side effect and bodily changes were added.
See this image and copyright information in PMC

References

    1. Dhont N, Ndayisaba GF, Peltier CA, Nzabonimpa A, Temmerman M, van de Wijgert J. Improved access increases postpartum uptake of contraceptive implants among HIV-positive women in Rwanda. Eur J Contracept Reprod Health Care. 2009. December;14(6): 420–425. doi: 10.3109/13625180903340584 - DOI - PubMed
    1. Elul B, Delvaux T, Munyana E, Lahuerta M, Horowitz D, Ndagije F, et al. Pregnancy desires, and contraceptive knowledge and use among prevention of mother-to-child transmission clients in Rwanda. AIDS. 2009. November;23 Suppl 1: S19–S26. doi: 10.1097/01.aids.0000363774.91376.dc - DOI - PubMed
    1. Leslie JA, Munyambanza E, Adamchak SE, Janowitz B, Grey TW, Kirota K. Without strong integration of family planning into PMTCT services in Rwanda, clients remain with a high unmet need for effective family planning. Afr J Reprod Health. 2010. December; 14(4 Spec no.): 144–146. - PubMed
    1. Rwanda Demographic and Health Survey 2014–2015 Key indicators. National Institute of Statistics of Rwanda, Ministry of Finance and Economic Planning, Ministry of Health, Kigali, Rwanda, The DHS Program, ICF International, Rockville, Maryland, USA. July 2015.
    1. Nath A, Sitruk-Ware R. Progesterone vaginal ring for contraceptive use during lactation. Contraception. 2010. November;82(5): 428–434. doi: 10.1016/j.contraception.2010.05.016 - DOI - PubMed

Publication types

LinkOut - more resources