MTN-032 was a qualitative study to understand what factors influenced women’s use or nonuse of the monthly dapivirine ring during their participation in ASPIRE (MTN-020), a placebo-controlled trial, and HOPE (MTN-025), the follow-on trial to ASPIRE in which former ASPIRE participants were offered the opportunity to use the dapivirine ring (there was no placebo) for one year. The study was conducted in two parts. Phase I involved 187 former ASPIRE participants who had been assigned to use the dapivirine ring and who took part in either a focus group or in-depth interview. Results, which were reported in 2018, found that women who didn’t use the ring regularly feared their partners would oppose its use or feel it during sex. High adherers expressed altruistic motivations for ring use. Phase 2 involved 58 former participants who opted to enroll in HOPE and 55 male partners. Results, first reported in 2019, found reasons for non-use of the ring included menses, vaginal discomfort and objections from their partner. For their part, male partners felt strongly that use of the ring should be a shared decision. Results overall provide important insight for facilitating real-world introduction of the dapivirine ring.
After ASPIRE: HOPE and other MTN Studies of the Dapivirine Ring