The Ring Plus Project: safety and accessibility of vaginal rings that protect women in Rwanda from unintended pregnancy

Kestelyn, Evelyn (2024). The Ring Plus Project: safety and accessibility of vaginal rings that protect women in Rwanda from unintended pregnancy. PhD thesis The Open University.

DOI: https://doi.org/10.21954/ou.ro.00097645

Abstract

This thesis describes my journey to becoming a critical independent researcher starting with my Masters formations where I developed my interest in social sciences and public health through working as an investigator leading HIV and reproductive health research in Africa.It was in Rwanda that I realized there was limited understanding and research on beliefs and attitudes of new contraceptive methods and HIV prevention tools. Over the course of several years, I developed and implemented the Ring Plus study, a multidisciplinary research project, providing data on the safety, acceptability and adherence of a contraceptive vaginal ring (NuvaRing®) and on the effects of this ring on the vaginal microbiome in Rwandan women. Results from this study contributed to the production of new knowledge through several peer reviewed publications and other scientific outputs. Overall, our findings indicated that for Rwandan women intermittent and continuous NuvaRing® use was safe and acceptable. This work provides the policy makers and public health professionals in Rwanda with valuable information as to date this is the only data from Rwanda related to acceptability and safety to a vaginal ring with insight into how Rwandan women perceive and use a new contraceptive technology. This body of research demonstrates the importance of integrating mixed-methods into clinical trial settings and how our understanding of context specific knowledge should inform the introduction of complex interventions.

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