P50.05
Background: Adherence is key to ensuring effectiveness of ARV based microbicides. Adherence patterns may differ in a placebo controlled trial where efficacy is uncertain compared to an open-label trial of a product of known efficacy and also with increasing duration of follow-up. Participant experiences and challenges in adhering to using 1% tenofovir gel in CAPRISA 008 was assessed as part of ongoing adherence support.
Methods: Five group adherence support (GAS) sessions were conducted between January and February 2014 by a trained staff member. Participants who were enrolled in the study for>12 months volunteered to take part in these GAS sessions that comprised groups of 6-10 participants and lasted 60-90 minutes. Detailed notes transcribed during these sessions were reviewed to identify common themes and differences within and across sessions.
Results: A total of forty six women aged between 23–45 years participated in these GAS sessions. Common issues emerged regarding factors affecting adherence to gel use over time. Initial confidence about product use started to be eroded with time as they learned of participants becoming infected with HIV. In four out of five sessions it was reported that partner disclosure of gel use enhanced adherence. In three out of five sessions participants reported that unplanned coitus, partner complaints of vaginal wetness and leakage of gel, influenced adherence over time. In order to address these barriers to adherence participants suggested the following: inserting the gel earlier in the day to reduce wetness at the time of coitus especially if they have not disclosed gel use to their partner and storage of gel in convenient and multiple locations (i.e. cosmetic bag/pencil case) for easy access particularly when unplanned coitus takes place.
Conclusions: These pilot GAS sessions identified both barriers and facilitators to product adherence. Participants welcomed suggestions made by peers to enhance their product adherence levels.
