AIDS and Behavior

, Volume 22, Issue 3, pp 877–886 | Cite as

How Presentation of Drug Detection Results Changed Reports of Product Adherence in South Africa, Uganda and Zimbabwe

  • Petina MusaraEmail author
  • Elizabeth T. Montgomery
  • Nyaradzo M. Mgodi
  • Kubashni Woeber
  • Carolyne A. Akello
  • Miriam Hartmann
  • Helen Cheng
  • Lisa Levy
  • Ariana Katz
  • Cynthia I. Grossman
  • Z. Mike Chirenje
  • Ariane van der Straten
  • Barbara Mensch
  • On behalf of the Microbicide Trials Network-003D Study Team
Original Paper


Accurate estimates of study product use are critical to understanding and addressing adherence challenges in HIV prevention trials. The VOICE trial exposed a significant gap between self-reported adherence and drug detection. The VOICE-D qualitative study was designed to better understand non-adherence during VOICE, and was conducted in 2 stages: before (stage 1) and after (stage 2) drug detection results were provided to participants. Transcripts from 44 women who participated in both stages were analysed to understand the effect of presenting drug detection data on narratives of product use. Thirty-six women reported high adherence in stage 1, yet admitted non-use in stage 2, three reported high adherence in both stages (contrary to their drug detection results) and five had consistent responses across both stages and drug results. Presenting objective measures of use may facilitate more accurate product use reporting and should be evaluated in future prevention trials.


Drug detection results Adherence measures Pre-exposure prophylaxis Microbicides HIV prevention 



We would like to thank the participants of this study for their dedication, the MTN Leadership and Kailazarid Gomez-Feliciano for their contribution to the development, implementation and analysis of this study, and Amy J. Markowitz and Joelle Brown for mentoring. The full MTN003-D study team can be viewed at The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.


The study was designed and implemented by the Microbicide Trials Network (MTN) of the Division of AIDS (DAIDS) of the National Institute of Allergy and Infectious Diseases (NIAID), an institute of the U.S. National Institutes of Health (NIH). The Microbicide Trials Network is funded by NIAID Grants (UM1AI068633, UM1AI068615, 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. NIH.

Compliance with Ethical Standards

Conflicts of interest

All authors declare that they have no conflict of interest.

Ethical Approval

The study protocol was approved by the Institutional Review Boards at Research Triangle Institute International and at each of the study sites. Informed consent was obtained from all the participants enrolled in the study.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Petina Musara
    • 1
    Email author
  • Elizabeth T. Montgomery
    • 3
  • Nyaradzo M. Mgodi
    • 1
  • Kubashni Woeber
    • 2
  • Carolyne A. Akello
    • 6
  • Miriam Hartmann
    • 3
  • Helen Cheng
    • 3
  • Lisa Levy
    • 4
  • Ariana Katz
    • 3
  • Cynthia I. Grossman
    • 5
  • Z. Mike Chirenje
    • 1
  • Ariane van der Straten
    • 3
    • 7
  • Barbara Mensch
    • 8
  • On behalf of the Microbicide Trials Network-003D Study Team
  1. 1.University of Zimbabwe-University of California San Francisco Collaborative Research ProgrammeHarareZimbabwe
  2. 2.HIV Prevention Research UnitSouth African Medical Research CouncilCape TownSouth Africa
  3. 3.Women’s Global Health Imperative; RTI InternationalSan FranciscoUSA
  4. 4.FHI-360DurhamUSA
  5. 5.DAIDS/NIH/NIMHBethesdaUSA
  6. 6.Makerere University-Johns Hopkins University Research CollaborationKampalaUganda
  7. 7.Center for AIDS Prevention StudiesUCSFSan FranciscoUSA
  8. 8.Population CouncilNew YorkUSA

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