End-user preference for and choice of four vaginally delivered HIV prevention methods among young women in South Africa and Zimbabwe: the Quatro Clinical Crossover Study
End-user preference for and choice of four vaginally delivered HIV prevention methods among young women in South Africa and Zimbabwe: the Quatro Clinical Crossover Study
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DOI：
10.1002/jia2.25283
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发表时间：
2019-05-01
影响因子：
6
通讯作者：
van der Straten, Ariane
中科院分区：
文献类型：
--
作者：
Montgomery, Elizabeth T.;Beksinska, Mags;van der Straten, Ariane
导言：坚持艾滋病毒预防方法是一项挑战，特别是对撒哈拉以南非洲的年轻妇女而言。在产品开发过程中的最终用户的研究可以告知修改的因素，以增加未来的摄取和adherence.Methods：四阴道插入安慰剂艾滋病预防方法的偏好进行了评估津巴布韦和南非的年轻女性使用交叉临床设计。对于第1至4个月的每一个月，要求参与者使用性交前插入的薄膜，插入物（阴道片剂）和凝胶，每周一次，持续一个月，并按随机分配的顺序每月使用一次环。参与者随后选择一种首选产品，按照指示在最后一个研究月使用。妇女排名的四个产品，从最喜欢的最不喜欢在登记和尝试所有products.Results后：共200名妇女，年龄在18至30岁（平均23）参加了178（89%）完成后续。在基线时，41%的参与者选择凝胶作为他们最喜欢的产品，61%的人选择戒指作为最不喜欢的产品。在交叉期间，大多数（82%至85%）自我报告每周至少使用一次每种产品，尽管只有一半的时间与性有关。客观的生物标志物数据证实了所有产品的充分使用。在尝试了每种产品后，排名发生了变化，选择薄膜，环，插入物和凝胶的比例分别为29%，28%，26%和16%。不同国家的选择差异显著（p < 0.001）：更多的津巴布韦人选择了电影（45%），更多的南非人选择了插页（34%）。在选择戒指的女性中，88%的人报告每次做爱都会使用它。相比之下，自我报告的依从性较低的“按需”（性交相关）产品，40%至55%的使用他们每次在性行为（p < 0.001）。结论：偏好这四种剂型使用前和使用后，并在国内和国家之间-没有明确的最爱-表明需要一系列的选择，为最终用户。戒指的受欢迎程度随着使用而增加，是第二大首选的交付系统，并且根据自我报告，在性生活中提供了更多的覆盖范围。这些最终用户的观点为产品开发人员和资助机构提供了重要信息。
Introduction: Adherence to HIV prevention methods is a challenge, particularly for young women in Sub-Saharan Africa. End-user research during product development can inform modifiable factors to increase future uptake and adherence.Methods: Preferences for four vaginally inserted placebo HIV prevention methods were assessed among Zimbabwean and South African young women using a crossover clinical design. For each of months 1 to 4, participants were asked to use a pre-coitally inserted film, insert (vaginal tablet) and gel once/week for a month, and a monthly ring in a randomly assigned sequence. Participants subsequently chose one preferred product to use as directed for the final study month. Women ranked the four products from most preferred to least preferred at enrolment and after trying all products.Results: A total of 200 women aged 18 to 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% to 85%) self-reported using each product at least once a week, although only half the time with sex. Objective biomarker data confirmed adequate use of all products. After trying each product, rankings changed with the film, ring, insert and gel being selected by 29%, 28%, 26% and 16% respectively. Choice varied significantly by country (p < 0.001): More Zimbabweans chose the film (45%), and more South Africans chose the insert (34%). Among women choosing the ring, 88% reported using it every time with sex. By contrast, self-reported adherence was lower for "on-demand" (coitally associated) products, with 40% to 55% using them every time during sex (p < 0.001).Conclusions: Preferences for these four dosage forms varied before and after use, and both within and across countries - there was no clear favourite - indicating the need for a range of options for end-users. 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.