Vaginal Ring Adherence in Sub-Saharan Africa: Expulsion, Removal, and Perfect Use

被引：71

作者：

Montgomery, Elizabeth T. ^{[1
]}

van der Straten, A. ^{[1
,2
]}

Cheng, H. ^{[1
]}

Wegner, L. ^{[1
]}

Masenga, G. ^{[3
]}

von Mollendorf, C. ^{[4
]}

Bekker, L. ^{[5
,6
]}

Ganesh, S. ^{[7
]}

Young, K. ^{[8
]}

Romano, J. ^{[9
]}

Nel, A. ^{[8
]}

Woodsong, C. ^{[8
]}

机构：

[1] RTI Int, Womens Global Hlth Imperat, Res Triangle Inst, San Francisco, CA 94104 USA

[2] Univ Calif San Francisco, Dept Med, Ctr AIDS Prevent Studies, San Francisco, CA USA

[3] Kiliminjaro Christian Med Ctr, Moshi, Tanzania

[4] Wits Reprod Hlth & HIV Res Inst, Johannesburg, South Africa

[5] Univ Cape Town, ZA-7925 Cape Town, South Africa

[6] Desmond Tutu HIV Fdn, Cape Town, South Africa

[7] S African MRC, Durban, South Africa

[8] Int Partnership Microbicides, Paarl, South Africa

[9] NWJ Grp LLC, Wayne, PA USA

来源：

AIDS AND BEHAVIOR | 2012年 / 16卷 / 07期

关键词：

Vaginal ring; Adherence; Sub-Saharan Africa; Female-controlled HIV prevention methods; Microbicide delivery; INTRAVAGINAL RINGS; HIV PREVENTION; ACCEPTABILITY; DELIVERY; SAFETY; NUVARING(R); ZIMBABWE; TRIAL; WOMEN;

D O I：

10.1007/s10461-012-0248-4

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

In sub-Saharan Africa, HIV incidence and prevalence remain disproportionately high among women. Vaginal rings (VRs) have been formulated for the delivery of antiretroviral-based microbicides, and their favorable safety and tolerability profiles reported in clinical studies. Although the concept of drug release through a VR has existed since 1970, and VRs have been marketed since 1992 for contraceptive or hormone replacement purposes, VR use as a microbicide delivery system is a novel application. This is the first study to evaluate VR adherence among African women in the context of its potential use as an HIV prevention method, to examine predictors of adherence, and to describe clinical or contextual reasons for VR removals or nonadherence. This was a randomized trial of the safety and acceptability of a placebo VR worn for 12 weeks in 170 HIV-negative, African women aged 18-35 in four clinic sites in South Africa and Tanzania. The findings suggest that adherence to VR use in the context of HIV prevention trials in these communities should be high, thereby enabling more accurate assessment of an active microbicide safety and efficacy.

引用

页码：1787 / 1798

页数：12