MTN-041 | Microbicide Trials Network

MTN-041, also known as the MAMMA study, was a qualitative study that took place in Malawi, South Africa, Uganda and Zimbabwe to understand community belief systems and attitudes that may affect women’s perceptions about and potential interest in using the monthly dapivirine vaginal ring or daily PrEP during pregnancy and breastfeeding and help inform implementation of the DELIVER (MTN-042) and B-PROTECTED (MTN-043) studies of these products in pregnant and breastfeeding women, respectively. MTN-041 involved group discussions with pregnant and breastfeeding women, male partners and mothers and mothers-in-law of pregnant and breastfeeding women and interviews with community leaders, healthcare providers, midwives and traditional birth attendants, among others. Across all groups, there was an appreciation that women were at high risk of HV during pregnancy and breastfeeding and a need for different methods of protection such as the vaginal ring and oral PrEP. For these products to be accepted, many felt buy-in of healthcare providers would be key. The influence that male partners have over women’s decision making and behavior was also emphasized, though in some settings, mothers and mothers-in-laws were deemed equally, if not more, influential. (See also DELIVER and B-PROTECTED.)