End‐user preference for and choice of four vaginally delivered HIV prevention methods among young women in South Africa and Zimbabwe: the Quatro Clinical Crossover Study

作者：Elizabeth Montgomery, Mags Beksinska, Nyaradzo Mgodi, Jill L. Schwartz, Rachel Weinrib, Erica N. Browne, Nonhlanhla Mphili, Petina Musara, Manjeetha Jaggernath, Susan Ju, Jenni Smit, Zvavahera M. Chirenje, Gustavo F. Doncel, Ariane van der Straten · 发表于：Journal of the International AIDS Society · 年份：2019 · DOI：10.1002/jia2.25283 · 被引用次数：56 · 研究领域：HIV/AIDS Research and Interventions、Adolescent Sexual and Reproductive Health、Mobile Health and mHealth Applications

INTRODUCTION: Adherence to HIV prevention methods is a challenge, particularly for young women in Sub-Saharan Africa. End-user research during product development can inform modifiable factors to increase future uptake and adherence. METHODS: Preferences for four vaginally inserted placebo HIV prevention methods were assessed among Zimbabwean and South African young women using a crossover clinical design. For each of months 1 to 4, participants were asked to use a pre-coitally inserted film, insert (vaginal tablet) and gel once/week for a month, and a monthly ring in a randomly assigned sequence. Participants subsequently chose one preferred product to use as directed for the final study month. Women ranked the four products from most preferred to least preferred at enrolment and after trying all products. RESULTS: A total of 200 women aged 18 to 30 (mean 23) were enrolled; 178 (89%) completed follow-up. At baseline, 41% of participants selected the gel as their most preferred product and 61% selected the ring as least preferred. During the crossover period, most (82% to 85%) self-reported using each product at least once a week, although only half the time with sex. Objective biomarker data confirmed adequate use of all products. After trying each product, rankings changed with the film, ring, insert and gel being selected by 29%, 28%, 26% and 16% respectively. Choice varied significantly by country (p < 0.001): More Zimbabweans chose the film (45%), and more South Africans...