Higher Acceptability of the Monthly Dapivirine Ring Versus Daily Oral Pre-Exposure Prophylaxis Among Adolescent Girls and Young Women in Sub-Saharan Africa in the REACH Trial

作者：Barbara Friedland, Erica N. Browne, Sarah T. Roberts, Kenneth Ngure, Rita Nakalega, Pippa Macdonald, Cynthia Nombeko Mpongo, Siyanda Tenza, Nomsa Mhlanga, Danny Szydlo, Sherri Johnson, Tara McClure, Gonasagrie Nair, Connie Celum, Sharon L. Hillier, Ariane van der Straten · 发表于：JAIDS Journal of Acquired Immune Deficiency Syndromes · 年份：2025 · DOI：10.1097/qai.0000000000003756 · 被引用次数：3 · 研究领域：HIV/AIDS Research and Interventions、Adolescent Sexual and Reproductive Health、Ethics in Clinical Research

BACKGROUND: Oral pre-exposure prophylaxis (PrEP) is effective for HIV prevention , yet use has been inconsistent in adolescent girls and young women (AGYW). We compared PrEP with the dapivirine vaginal ring (ring) among AGYW in MTN-034 (REACH). METHODS: We randomized 247 16-21-yr-old AGYW (South Africa, Uganda, Zimbabwe) to the sequence of using the ring and oral PrEP for 6 m each (February 2019-September 2021). Participants rated overall product acceptability (1, dislike very much to 5, like very much) after 3 m and 6 m, and product characteristics/use attributes after 3 m. We compared proportions of participants rating each product a "5" (binomial model with generalized estimating equations). We assessed associations between product characteristics/use attribute ratings at 3 m and overall acceptability after 6 m (χ 2 ). RESULTSOVERALL,: 65% and 41% of participants rated the ring versus PrEP a "5" (adjusted risk difference [aRD] 24%, 95% CI: 15%, 32%; P < 0.001). For both products, high overall acceptability was associated with "excellent" self-rated adherence (ring, P < 0.001; PrEP, P = 0.03), product appearance (ring, P = 0.005; PrEP, P < 0.001), and ease of use (ring, P = 0.001; PrEP, P = 0.003). Not worrying about/or experiencing side effects were also associated with high acceptability of oral PREP. CONCLUSIONS: The dapivirine ring was highly acceptable to substantially more individuals than oral PrEP, although a significant minority rated oral PrEP highly, even after u...