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Demystifying myths and misconceptions about use of the Dapivirine Vaginal Ring and Truvada among adolescent girls and young women in the MTN-034 study; observations from Kampala site

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BACKGROUND: Communities in Africa have a major influence on the behaviors of adolescent girls and young women (AGYW) and their opinions are highly valued in the decision making processes of this young and vulnerable population at risk of HIV infection. Since myths and misconceptions have the potential to affect the utilization of the dapivirine vaginal ring (Ring) and Truvada while also affecting the research process, it is imperative that researchers understand the concerns and also find means to address them. We seek to explore the myths and misconceptions about the use of the Ring and the Truvada tablet among AGYW in the MTN 034 study at Kampala and also describe the strategies adopted to mitigate them.
METHODS: The MTN-034 is an ongoing, cross-over study of daily oral PrEP and monthly dapivirine vaginal ring safety and preferences, From June 2019 to Feb 2020, 26 adherence support meetings were held with about 15-20 participants attending each of these bi-weekly sessions. Additionally, one-on-one counselling sessions, community sensitization meetings, and parents/guardians meetings are held during study implementation. Summary notes are used to record the myths and misconceptions including challenges and proposed solutions that arise during these sessions.
RESULTS:

Myths and Misconceptions

Ring

Truvada

Study Product

It causes cancer of reproductive organs

Causes barrenness

Widens the vagina

May disappear in the body and go to lungs

Loops the partner's penis

Sucks blood from the sexual partner

Truvada can infect one with HIV

Causes extensive liver damage

Causes abdominal swellings, tumors and infertility

Causes weight gain and body deformation ' big head, thin legs etc.

The drug also piles in the lungs and can cause sudden death.

Study Participation

Researchers are taking blood to use it for sale and manipulation of African genes

The examination lump burns the vagina during the pelvic exam

Vaginal specimen will be used to design products that make African infertile.


The team addressed these myths and misconceptions by providing accurate information about the study and study products to participants and community members. Participant and community engagement sessions plus scheduled counselling visits were a platform to dispel misconceptions.


CONCLUSIONS: Implementation of interventions requires sensitization of communities prior to study initiation to mitigate myths and misconceptions. Continuous education and engagement of communities, as well as participants, is key to dispelling myths and misconceptions.