{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T19:53:36Z","timestamp":1783367616142,"version":"3.54.6"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Despite the availability of HIV preventive measures, new HIV infections are still on the rise. The Dapivirine Vaginal Ring (DVR) is a silicone circular ring that continuously distributes 25\u2009mg of Dapivirine into a woman's vagina for 28 days to prevent HIV infection; however, the effectiveness of DVR is largely dependent on adherence. To date, adherence to DVR has not been aggregated and summarized. The objective of this systematic review is to summarize the evidence on adherence to DVR for HIV\u20101 prevention among African women and to aggregate findings into a quantitative estimate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We will conduct a systematic review of studies in which DVR has been used to prevent HIV\u20101 in African women. We will search MEDLINE, Global Health, CINAHL, and EMBASE from database inception to December 2024. We will include observational studies and randomized trials of women between 15 and 49 years of age, resident in Africa, who have used the DVR. Our primary outcome will be adherence to DVR. Pairs of reviewers will independently screen for eligible studies and will extract relevant data. We will perform a random\u2010effects meta\u2010analysis for DVR adherence. Certainty of the evidence will be assessed using the GRADE approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This systematic review and meta\u2010analysis will contribute to a better understanding of how DVR adherence aids in preventing HIV\u20101 infection in women, as well as the factors that influence observed adherence. Its findings can provide important foundational knowledge for future research and innovation in DVR and other PrEP tools. Findings from this protocol article will be disseminated as peer\u2010reviewed publications, at conferences, and as part of a master's thesis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.71057","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T04:54:52Z","timestamp":1753332892000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Adherence to the Dapivirine Vaginal Ring Among Cisgender Women in Africa: Protocol for a Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8210-9258","authenticated-orcid":false,"given":"Roseline Dzekem","family":"Dine","sequence":"first","affiliation":[{"name":"Department of Health Research Methods, Evidence and Impact McMaster University Hamilton Canada"},{"name":"Department of Social Sciences and Community Engagement Rinda Ubuzima Kigali Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Muraca","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence and Impact McMaster University Hamilton Canada"},{"name":"Department of Anesthesia McMaster University Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behnam","family":"Sadeghirad","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence and Impact McMaster University Hamilton Canada"},{"name":"Department of Anesthesia McMaster University Hamilton Canada"},{"name":"Michael G. DeGroote Institute for Pain Research and Care McMaster University Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Mbuagbaw","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence and Impact McMaster University Hamilton Canada"},{"name":"Department of Anesthesia McMaster University Hamilton Canada"},{"name":"Department of Pediatrics McMaster University Hamilton Canada"},{"name":"Biostatistics Unit, Father Sean O'Sullivan Research Centre St Joseph's Healthcare Hamilton Canada"},{"name":"Centre for Development of Best Practices in Health (CDBPH) Yaound\u00e9 Central Hospital Yaound\u00e9 Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"UNAIDS \u201cGlobal HIV & AIDS Statistics\u2014Fact Sheet [Internet] \u201d [cited 2024 Jun 11] https:\/\/www.unaids.org\/en\/resources\/fact-sheet."},{"key":"e_1_2_11_3_1","unstructured":"CDC \u201cPre\u2010Exposure Prophylaxis (PrEP) HIV Risk and Prevention HIV\/AIDS \u00a0CDC [Internet] \u201d2023 https:\/\/www.cdc.gov\/hiv\/risk\/prep\/index.html."},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(20)30304-0"},{"key":"e_1_2_11_5_1","unstructured":"NIH \u201cPre\u2010Exposure Prophylaxis (PrEP) to Prevent HIV NIAID: National Institute of Allergy and Infectious Diseases [Internet] \u201d2024 https:\/\/www.niaid.nih.gov\/diseases-conditions\/pre-exposure-prophylaxis-prep."},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1955-7"},{"key":"e_1_2_11_7_1","unstructured":"WHO \u201cHIV and AIDS [Internet] \u201d [cited 2024 Jun 11] https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hiv-aids?gad_source=1&gclid=CjwKCAjw65-zBhBkEiwAjrqRMBdZtIajutR5N-M2bPn_Qys-QXoSBzUpC7pfNatSMcubgYPrjwVmSRoCWxoQAvD_BwE."},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw832"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10508-020-01880-y"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(24)00048-3"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1506110"},{"key":"e_1_2_11_12_1","unstructured":"WHO \u201cWHO Recommends the Dapivirine Vaginal Ring as a New Choice for HIV Prevention for Women at Substantial Risk of HIV infection [Internet] \u201d [cited 2024 Jun 11] https:\/\/www.who.int\/news\/item\/26-01-2021-who-recommends-the-dapivirine-vaginal-ring-as-a-new-choice-for-hiv-prevention-for-women-at-substantial-risk-of-hiv-infection."},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000897"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000280"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.antiviral.2013.09.025"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0147743"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602046"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(20)30300-3"},{"key":"e_1_2_11_19_1","unstructured":"south_africa_ring_guidelines_2_december_2022_signed_updated.pdf [Internet]. 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