Acceptability of the Dapivirine Vaginal Ring for HIV-1 Prevention and Association with Adherence in a Phase III Trial

• DOI: 10.1007/s10461-021-03205-z
• Publication Date: 2021-03-13T15:02:46Z
• Authors: Ashley J. Mayo; Erica N. Browne; Elizabeth T. Mont...; Kristine Torjesen; Thesla Palanee-Ph...; Nitesha Jeenarain; Linly Seyama; Kubashni Woeber; Ishana Harkoo; Krishnaveni Reddy; Tchangani Tembo; Prisca Mutero; Thelma Tauya; Miria Chitukuta; Brenda Gati Mirembe; Lydia Soto-Torres; Elizabeth R. Brown; Jared M. Baeten; Ariane van der St...; ; Jared Baeten; Thesla Palanee-Ph...; Elizabeth Brown; Lydia Soto-Torres; Katie Schwartz; Bonus Makanani; Francis Martinson; Linda-Gail Bekker; Vaneshree Govender; Samantha Siva; Zakir Gaffoor; Logashvari Naidoo; Arendevi Pather; Nitesha Jeenarain; Gonasagrie Nair; Flavia Matovu; Nyaradzo Mgodi; Felix Mhlanga
• Keywords: Vaginal ring; Pre-exposure prophylaxis

Abstract We evaluated the acceptability of 25 mg dapivirine vaginal ring (DVR) as an HIV prevention intervention and its influence on DVR adherence in MTN-020/ASPIRE phase III trial. Acceptability measures were captured using ACASI at month 3 end product use (median 24 months, IQR 15–30). Monthly returned rings classified nonadherent if release rate was ≤ 0.9 mg/month. Associations between nonadherence estimated Poisson regression models with robust standard errors. At (N = 2334), 88% reported comfortable, 80% unaware it during daily activities, 74% never felt sex. exit, 66% ‘very likely’ to future. found differ significantly by country across several including wearing sex, menses, partner acceptability, impact sexual pleasure willingness Risk 12 elevated sex (aRR 1.67, 95% CI 1.26, 2.23). last year study participation if, participants minded 2.08, 1.52, 2.85), menses 1.57, 1.06, 2.32), a problematic change environment 1.12, 2.21), not “very likely” future 1.31, 1.02, 1.68). overall high yet varied country. Addressing perceived interference or changes interventions could help improve adherence, embracing sex-positive messaging related increased pleasure. Trial Registration ClinicalTrials.gov Identifier: NCT01617096.