Women’s experience receiving drug feedback and adherence counseling in MTN-025/HOPE - an HIV Prevention open-label trial of the Dapivirine Vaginal Ring

In the Phase IIIB MTN-025/HOPE open label extension trial, participants were offered the dapivirine vaginal ring as HIV prophylaxis, and those who accepted the ring received semi real-time individual adherence feedback, based on residual drug level (RDL) from returned rings, during Motivational Inte...

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Bibliographic Details
Published in:AIDS and behavior 2022-11, Vol.26 (11), p.3607-3619
Main Authors: Katz, Ariana Wendy Keel, Balán, Iván C., Reddy, Krishnaveni, Etima, Juliane, Weber, Kubashni, Tauya, Thelma, Atujuna, Millicent, Scheckter, Rachel, Ngure, Kenneth, Soto-Torres, Lydia, Mgodi, Nyaradzo, Palanee-Phillips, Thesla, Baeten, Jared M., van der Straten, Ariane
Format: Article
Language:English
Subjects:
Counseling
Disease prevention
Drug abuse
Drugs
Feedback
Health Psychology
HIV
Human immunodeficiency virus
Infectious Diseases
Interviews
Medicine
Medicine & Public Health
Motivation
Original Paper
Patient compliance
Patient satisfaction
Prevention
Prophylaxis
Protection
Public Health
Vagina
Womens health
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Summary:In the Phase IIIB MTN-025/HOPE open label extension trial, participants were offered the dapivirine vaginal ring as HIV prophylaxis, and those who accepted the ring received semi real-time individual adherence feedback, based on residual drug level (RDL) from returned rings, during Motivational Interviewing-based counseling. Counseling messages, based on the best knowledge at the time, framed RDL results in terms of ring use and HIV protection, from no use /no protection (0 RDL) to high use /high protection (3 RDL). At six HOPE sites, in-depth-Interviews (IDIs) about RDL were conducted with 64 participants who had received at least one RDL result. We found mixed interpretations of what the RDL meant and strong emotional reactions with a focus on the external validation of the level itself. Counseling was critical to help participants process their reactions to the RDL and make decisions accordingly (i.e., persistence, adherence improvement, and/or switching to another HIV prevention method). Providing drug adherence feedback was complex to implement yet proved useful as a component of a multi-pronged adherence support strategy.
ISSN:1090-7165
1573-3254
DOI:10.1007/s10461-022-03663-z