PDF(Pubmed)
Abstract：
OBJECTIVE: The dapivirine vaginal ring is a self-administered, women-initiated, discreet, long-acting HIV-1 prevention option for women. It was found to be safe and effective in healthy HIV-negative women who adhered to product use instructions, and has been approved for use in women aged 18 and older in some African countries. A qualitative study was conducted to explore participants\' and their male partners\' discussions on accidental/purposeful vaginal ring removals during The Ring Study (IPM 027 clinical trial).
METHODS: Data were collected via in-depth interviews and focus group discussions with female trial participants and their male partners, from seven research centres in South Africa and Uganda. Data were thematically analysed using NVivo.
RESULTS: More participants reported purposeful ring removals than accidental expulsions. Various factors influenced purposeful ring removal - including individual (discomfort during use/sex and to clean it), partner (to show them, because of discomfort during sex, to test if partners could feel it, and concerns of harm), organisational (doctor\'s request), and socio-cultural (rumours about sickness and infertility). Some described their own ring use removal, others discussed why other participants removed their rings.
CONCLUSIONS: Vaginal ring adherence is critical to improve and support product efficacy. Counselling on vaginal anatomy, vaginal ring insertion and importance of adherence is important to minimise vaginal ring removal. Couples counselling is also important to facilitate support and long-term vaginal ring adherence behaviour. Understanding factors influencing vaginal ring adherence is important for tailoring and targeting messages to support correct and consistent vaginal ring use as it is made available to the public.
METHODS: Data were collected via in-depth interviews and focus group discussions with female trial participants and their male partners, from seven research centres in South Africa and Uganda. Data were thematically analysed using NVivo.
RESULTS: More participants reported purposeful ring removals than accidental expulsions. Various factors influenced purposeful ring removal - including individual (discomfort during use/sex and to clean it), partner (to show them, because of discomfort during sex, to test if partners could feel it, and concerns of harm), organisational (doctor\'s request), and socio-cultural (rumours about sickness and infertility). Some described their own ring use removal, others discussed why other participants removed their rings.
CONCLUSIONS: Vaginal ring adherence is critical to improve and support product efficacy. Counselling on vaginal anatomy, vaginal ring insertion and importance of adherence is important to minimise vaginal ring removal. Couples counselling is also important to facilitate support and long-term vaginal ring adherence behaviour. Understanding factors influencing vaginal ring adherence is important for tailoring and targeting messages to support correct and consistent vaginal ring use as it is made available to the public.
摘要：
目的：dapivirine阴道环是自行给药的，女性发起的，谨慎,妇女的长效HIV-1预防选择。发现对坚持产品使用说明的健康HIV阴性女性安全有效,在一些非洲国家，已被批准用于18岁及以上的女性。进行了一项定性研究，以探讨参与者及其男性伴侣在环研究（IPM027临床试验）期间对意外/有目的的阴道环去除的讨论。
方法：通过与女性试验参与者及其男性伴侣的深入访谈和焦点小组讨论收集数据。来自南非和乌干达的七个研究中心。使用NVivo对数据进行主题分析。
结果：更多的参与者报告了有目的的戒指移除而不是意外驱逐。各种因素影响了有目的的戒指移除-包括个人（使用/性行为期间的不适和清洁），合伙人(向他们展示，因为性爱过程中的不适,来测试伴侣是否能感觉到，和对伤害的担忧)，组织(医生的要求)，和社会文化（关于疾病和不育的谣言）。有人描述了自己的戒指使用拆卸，其他人讨论了为什么其他参与者摘下他们的戒指。
结论：阴道环依从性是提高和支持产品疗效的关键。关于阴道解剖的咨询，阴道环插入和坚持的重要性是重要的，以尽量减少阴道环去除。夫妻咨询对于促进支持和长期的阴道环依从性行为也很重要。了解影响阴道环依从性的因素对于定制和定位信息以支持正确和一致的阴道环使用是重要的，因为它是向公众提供的。
方法：通过与女性试验参与者及其男性伴侣的深入访谈和焦点小组讨论收集数据。来自南非和乌干达的七个研究中心。使用NVivo对数据进行主题分析。
结果：更多的参与者报告了有目的的戒指移除而不是意外驱逐。各种因素影响了有目的的戒指移除-包括个人（使用/性行为期间的不适和清洁），合伙人(向他们展示，因为性爱过程中的不适,来测试伴侣是否能感觉到，和对伤害的担忧)，组织(医生的要求)，和社会文化（关于疾病和不育的谣言）。有人描述了自己的戒指使用拆卸，其他人讨论了为什么其他参与者摘下他们的戒指。
结论：阴道环依从性是提高和支持产品疗效的关键。关于阴道解剖的咨询，阴道环插入和坚持的重要性是重要的，以尽量减少阴道环去除。夫妻咨询对于促进支持和长期的阴道环依从性行为也很重要。了解影响阴道环依从性的因素对于定制和定位信息以支持正确和一致的阴道环使用是重要的，因为它是向公众提供的。
