Fostering adherence and open communication about adherence challenges is key to harnessing the potential of biomedical HIV prevention products. We describe the counseling intervention and objective adherence measure feedback process implemented to support adherence to the dapivirine vaginal ring among participants in four sub-Saharan countries and present findings on the counselors’ likeability and acceptability of the intervention. Most counselors (N = 42; 86%) liked Options counseling “very much” and during in-depth interviews (N = 22), reported that the intervention reshaped their adherence counselling approach by emphasizing understanding participants’ experiences using the ring, which facilitated open discussion of adherence challenges. Counselors found that reframing residual drug level (RDL) discussions from the “adherence” to “protection” perspective encouraged adherence among consistent users and facilitated decisions to switch to a different HIV prevention approach among infrequent users. Among counselors, 24% said participants “liked it very much” while 26% said that participants “liked it a little” possibly due to two main complaints: perceived repetitiousness of sessions and variability in the RDL assay, which at times resulted in unexpected low RDLs.

促进依从性和关于依从性挑战的公开交流是利用生物医学 HIV 预防产品潜力的关键。我们描述了为支持四个撒哈拉以南国家的参与者对达匹韦林阴道环的依从性而实施的咨询干预和客观依从性测量反馈过程，并介绍了咨询师对干预的喜爱度和可接受性的调查结果。大多数咨询师（N = 42；86%）“非常”喜欢 Options 咨询，并且在深入访谈期间（N = 22）报告说，干预通过强调了解参与者使用戒指的体验来重塑他们的依从性咨询方法，这有助于公开讨论依从性挑战。顾问们发现，将残留药物水平 (RDL) 讨论从“依从性”转变为“保护”的角度，鼓励了持续使用的使用者的依从性，并有助于决定在不经常使用的使用者中转向不同的 HIV 预防方法。在辅导员中，24% 的人表示参与者“非常喜欢它”，而 26% 的人表示参与者“有点喜欢它”可能是由于两个主要抱怨：感知到的会话重复性和 RDL 分析的可变性，这有时会导致意外的低RDL。