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A latent trajectory analysis of young sexual and gender minorities' adherence to three rectal microbicide placebo formulations (MTN-035; a randomized crossover trial).

  • Choi, Seul Ki1
  • Bauermeister, José2
  • Tingler, Ryan C2
  • Johnson, Sherri3
  • Macagna, Nicole3
  • Ho, Ken4, 5
  • Hoesley, Craig6
  • Liu, Albert7
  • Kayange, Noel8
  • Palanee-Phillips, Thesla9, 10
  • Chariyalertsak, Suwat11
  • Gonzales, Pedro12
  • Piper, Jeanna M13
  • 1 Department of Family and Community Health, School of Nursing, University of Pennsylvania, 418 Curie Blvd, Room 235L, Philadelphia, PA, 19104, USA. [email protected].
  • 2 Department of Family and Community Health, School of Nursing, University of Pennsylvania, 418 Curie Blvd, Room 235L, Philadelphia, PA, 19104, USA.
  • 3 , FHI 360, Durham, NC, USA.
  • 4 Magee-Women's Research Institute, Pittsburgh, PA, USA.
  • 5 Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
  • 6 University of Alabama at Birmingham, Birmingham, AL, USA.
  • 7 San Francisco Department of Public Health, San Francisco, CA, USA.
  • 8 Johns Hopkins University Research Project, Blantyre, Malawi. , (Malawi)
  • 9 Faculty of Health Sciences, School of Public Health, Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa. , (South Africa)
  • 10 Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA.
  • 11 Faculty of Public Health, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand. , (Thailand)
  • 12 IMPACTA, San Miguel, Peru. , (Peru)
  • 13 Division of AIDS/NIAID/NIH, Bethesda, MD, USA.
Published Article
BMC Public Health
Springer (Biomed Central Ltd.)
Publication Date
Dec 08, 2023
DOI: 10.1186/s12889-023-17368-y
PMID: 38066471


Rectal microbicides (RM) are biomedical HIV prevention products that aim to prevent or reduce the transmission of HIV and other sexually transmitted infections (STIs). RM modalities may be beneficial for populations who have complex lifestyles, difficulties adhering to pre-exposure prophylaxis (PrEP) regimens, and/or have limited access to care. MTN-035 (DESIRE; Developing and Evaluating Short-Acting Innovations for Rectal Use), a randomized crossover trial, aimed to evaluate the safety and acceptability of, and adherence to, three placebo RM modalities (douche, insert, and suppository) prior to receptive anal intercourse. We conducted latent trajectory analysis to identify clusters of individuals who shared similar trajectories in acceptability and adherence for each product (douche, insert, and suppository) over time. We analyzed weekly short messaging service (SMS) use reports for each modality as reported by enrolled sexual and gender minority (SGM) participants. Two trajectories for each product were identified: a "protocol compliant" trajectory (i.e., at least one product use occasion per week) and "high use" trajectory (i.e., more than three product use occasions per week). Participants with high use were more likely to lack access to PrEP and have higher intentions to utilize RM modalities compared to those who were protocol compliant. This study highlighted high adherence to RM modalities among SGM. As research into viable HIV prevention modalities continues to evolve, tailored intervention strategies are needed to support the uptake of and adherence to alternative prevention modalities that are behaviorally congruent with targeted users. NCT03671239 (14/09/2018). © 2023. The Author(s).

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