Open AccessClient-Centered Adherence Counseling with Adherence Measurement Feedback to Support Use of the Dapivirine Ring in MTN-025 (The HOPE Study)
Author(s) -
Iván C. Balán,
Rebecca Giguere,
Cody Lentz,
Bryan A. Kutner,
Clare Kajura-Manyindo,
Rose Byogero,
Florence Biira Asiimwe,
Yvonne Makala,
Jane Jambaya,
Nombuso Khanyile,
Diane Chetty,
Lydia SotoTorres,
Ashley J. Mayo,
Nyaradzo Mgodi,
Thesla PalaneePhillips,
Jared M. Baeten
Publication year - 2020
Publication title -
aids and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.994
H-Index - 106
eISSN - 1573-3254
pISSN - 1090-7165
DOI - 10.1007/s10461-020-03011-z
Subject(s) - intervention (counseling) , human immunodeficiency virus (hiv) , cognitive reframing , health psychology , psychology , medicine , vaginal ring , clinical psychology , nursing , psychotherapist , family medicine , public health , environmental health , research methodology , population , family planning
Fostering adherence and open communication about adherence challenges is key to harnessing the potential of biomedical HIV prevention products. We describe the counseling intervention and objective adherence measure feedback process implemented to support adherence to the dapivirine vaginal ring among participants in four sub-Saharan countries and present findings on the counselors' likeability and acceptability of the intervention. Most counselors (N = 42; 86%) liked Options counseling "very much" and during in-depth interviews (N = 22), reported that the intervention reshaped their adherence counselling approach by emphasizing understanding participants' experiences using the ring, which facilitated open discussion of adherence challenges. Counselors found that reframing residual drug level (RDL) discussions from the "adherence" to "protection" perspective encouraged adherence among consistent users and facilitated decisions to switch to a different HIV prevention approach among infrequent users. Among counselors, 24% said participants "liked it very much" while 26% said that participants "liked it a little" possibly due to two main complaints: perceived repetitiousness of sessions and variability in the RDL assay, which at times resulted in unexpected low RDLs.