Knowledge, Attitudes, and Experiences of HIV Pre-Exposure Prophylaxis (PrEP) Trial Participants in Botswana ()
ABSTRACT
Recent clinical trials have shown that a
daily dose of oral TDF/FTC pre-exposure prophylaxis (PrEP) is effective in
reducing human immunodeficiency (HIV) risk. Understanding trial participants’
perspectives about retention and PrEP adherence is critical to inform future
PrEP trials and the scale-up and implementation of PrEP programs. We analyzed
53 in-depth interviews conducted in April 2010 with participants in the TDF2
study, a Phase 3, randomized, double-blind, place-bo-controlled clinical trial
of daily oral TDF/FTC with heterosexual men and women in Francistown and
Gaborone, Botswana. We examined participants’ knowledge, attitudes, and
experiences of the trial, identified facilitators and barriers to enrollment
and retention, and compared participant responses by study site, sex, and study
drug adherence. Our findings point to several factors to consider for
participant retention and adherence in PrEP trials and programs, including conducting
pre-enrollment education and myth reduction counseling, providing accurate
estimates of participant obligations and side effect symptoms, ensuring
participant understanding of the effects of non-adherence, gauging personal
commitment and interest in study outcomes, and developing a strong external
social support network for participants.