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Abstracts of the HIV Research for Prevention Meeting, HIVR4P, 21-25 October, 2018, Madrid
Results of the Quatro randomized crossover trial
Montgomery, E., Beksinska, M., Mgodi, N., Schwartz, J., Weinrib, R., Browne, E., Mphili, N., Musara, P., Jaggernath, M., Ju, S., Smit, J., Chirenje, M., Doncel, G., & van der Straten, A. (2018). Abstracts of the HIV Research for Prevention Meeting, HIVR4P, 21-25 October, 2018, Madrid: Results of the Quatro randomized crossover trial. AIDS Research and Human Retroviruses, 34(S1), 26. https://doi.org/10.1089/aid.2018.5000.abstracts
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.
