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Pathways to High Adherence: An Adherence Support Manual for Vaginal Ring Trials

September 2016 — The Pathways to High Adherence manual was designed for research teams that are involved in supporting adherence to use of antiretroviral-based vaginal rings in HIV prevention clinical trials. Much of the content is also applicable to clinical trials of other HIV prevention products, such as oral pre-exposure prophylaxis, microbicide gels and vaginal films. This publication was developed under the Adherence Measurement and Optimization of Long-Acting ARV-Based Vaginal Ring Agreement, funded by the U.S. Agency for International Development.

The manual provides strategies to implement before, during and after clinical trials, along with case studies illustrating approaches that have been used to address adherence challenges. The authors intend the manual to help research teams support participant adherence to vaginal rings by focusing on the research teams’ engagement in the trial, as well as how interactions among researchers, participants and the community affect adherence. Users of the manual can select and adapt strategies that align with their specific contexts.