Meeting Abstract OA05.04
Background: Adherence to HIV prevention methods is a challenge, particularly for young women in Southern Africa. End-user research with during product development can inform modifiable factors to increase future uptake and adherence. Methods: A randomized crossover design assessed relative preferences, among Zimbabwean and South African women, of four intravaginal placebo dosage forms. For each of Months 1-4, participants were asked to use precoitally inserted film, insert (vaginal tablet) and gel once/week for a month, and a monthly ring. Participants subsequently chose one preferred product to use as directed for the final study month. Acceptability ratings, rankings relative to other products and product choice were measured. Results: 200 women aged 18-30 (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 (82-85%) self-reported using each product at least once a week, half the time with sex. There was nearly uniform distribution of products chosen for use during the final month: the film, ring, insert and gel were selected by 30%, 28%, 26% and 16%, respectively. Choice varied significantly by country (p< 0.001): most Zimbabweans chose the film (47%), and most South Africans chose the insert (35%). Among women choosing the ring, 88% reported using it every time with sex. By contrast, self-reported adherence was lower for on-demand products, with 40-55% using them every time during sex (p< 0.001). Conclusions: Preferences for these dosage forms varied before and after use, and by country. Furthermore, there was no dominant favorite, suggesting women want a range of prevention options. The ring’s popularity increased the most with use, was the second most preferred delivery system, and per self-report, provided more coverage during sex. These end-user perspectives provide important information to product developers and funding agencies.
