Abstract
Globally, HIV affects women disproportionally to men, particularly in sub-Saharan Africa. While the monthly dapivirine vaginal ring (VR) is a promising female-initiated HIV prevention method, it is important to understand how well the ring is liked. With former participants of HOPE, an open-label extension trial of the ring, we used emoji stickers and a worksheet to explore female end-user’s acceptability of and opinions about the VR. We aimed to understand these participants’ opinions about the VR, and how they had changed over time, particularly in the context of known efficacy of the dapivirine VR. Most participants easily understood the exercise and how to use the emoji stickers, with a few exceptions. For those who had trouble understanding how to use the emoji, interviewer support and encouragement helped them to understand and continue with the exercise. Emoji interpretation varied widely with participants using the same emoji to express divergent opinions. Using the emoji stickers, participants expressed mostly positive opinions of the vaginal ring for HIV prevention, with some lingering concerns about the product’s partial effectiveness. This paper contributes to the literature supporting the assertion that the dapivirine VR for HIV prevention is acceptable to women, and that acceptability increases with time and proper education. This analysis also provides evidence that emoji visual tools can enhance understanding of acceptability of an intervention when used in qualitative research.
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We did not receive consent from participants to make the study data available and thus the data will not be available to the public. If someone is interested in exploring the data they should contact the lead author.
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Acknowledgements
We would like to thank MTN-032 participants for their contribution to this research. The Microbicide Trials Network (MTN) leadership and operating center, FHI 360, and MTN-032 Protocol study team members are acknowledged as critical in the development, implementation, and/or analysis of this study. The full MTN-032 study team can be viewed at https://mtnstopshiv.org/research/studies/mtn-032.
Funding
The study was designed and implemented by the Microbicide Trials Network (MTN) funded by the National Institute of Allergy and Infectious Diseases through individual grants (UM1AI068633, UM1AI068615 and UM1AI106707), with co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Mental Health, all components of the U.S. National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The vaginal rings used in this study were supplied by the International Partnership for Microbicides (IPM).
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AWKK was involved in the study design, oversaw study implementation, data coding and analysis, data interpretation, and writing this article. LEM, MT, FM, DS, SS, CA, and THC were involved with study implementation at the study site, data collection, and article review. MG and LST were involved with overall study implementation and article review. ETM was involved in the study design, overall study implementation, data interpretation, and critical revision of this article.
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The study was approved by the Institutional Review Boards at RTI International, all study sites, and was overseen by the regulatory infrastructure of the US National Institutes of Health and the Microbicide Trials Network.
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Katz, A.W.K., Mansoor, L.E., Tsidya, M. et al. Using Emoji Stickers to Understand End-User Opinions of the Dapivirine Vaginal Ring for HIV Prevention. AIDS Behav 25, 3955–3966 (2021). https://doi.org/10.1007/s10461-021-03338-1
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DOI: https://doi.org/10.1007/s10461-021-03338-1