Sybil Hosek, PhD, and colleagues recently published an article in the Journal of International AIDS Society on the results of MTN-034, “Reversing the Epidemic in Africa with Choices in HIV Prevention” (REACH) trial. To address low PrEP uptake and persistence among adolescent girls and young women (AGYW) in sub-Saharan Africa, MTN-034/REACH offered AGYW a menu of adherence support strategies in a crossover trial implemented in South Africa, Uganda and Zimbabwe from January 2019 to September 2021. Findings, both qualitative and quantitative revealed high adherence to both daily oral PrEP and the monthly dapivirine vaginal ring by providing information about HIV and PrEP, continually motivating AGYW, and supporting their development of behavioral skills and self-efficacy. Three foundational pillars enhanced outcomes: strong interpersonal relationships with counsellors; ongoing, easily accessible support and resources; and trust in the counsellors and study products through counsellor relationships, peer-to-peer exchange and drug-level feedback (DLF). Offering a small menu of counsellor- and peer-based support options that are youth-friendly and developmentally appropriate can improve PrEP uptake and adherence for both ring and oral PrEP users, though content should be tailored to the individual products.
Roberts ST, Mancuso N, Williams K, Nabunya HK, Mposula H, Mugocha C, Mvinjelwa P, Garcia M, Szydlo DW, Soto-Torres L, Ngure K, Hosek S. How a menu of adherence support strategies facilitated high adherence to HIV prevention products among adolescent girls and young women in sub-Saharan Africa: a mixed methods analysis. J Int AIDS Soc. 2023 Nov;26(11):e26189. doi: 10.1002/jia2.26189. PMID: 37936551.