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HPTN 083 provided the first opportunity to understand experiences with injectable PrEP in a clinical trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants from two US sites (Chicago, IL and Atlanta, GA) and one international site (Rio de Janeiro, Brazil) were purposively sampled for individual qualitative interviews (<jats:italic>N<\/jats:italic> = 40), between November 2019 and March 2020, to explore trial experiences, barriers to adherence and other factors that may have impacted study implementation or outcomes. The blinded phase ended early due to efficacy; this analysis includes interviews conducted prior to unblinding with three groups defined by adherence (i.e. injection visit attendance): adherent (<jats:italic>n<\/jats:italic> = 27), non\u2010adherent (<jats:italic>n =<\/jats:italic> 12) and early discontinuers (<jats:italic>n<\/jats:italic> = 1). Data were organized using NVivo software and analysed using content analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants (mean age: 27) were primarily cisgender MSM (90%) and Black\/African American (60%). Reasons for trial enrolment and PrEP use included a preference for using HIV prevention medication versus treatment in the event of HIV acquisition; the ability to enhance health via study\u2010related education and services; access to a novel, convenient HIV prevention product at no cost; and contributing to MSM\/TGW communities through research. Participants contrasted positive experiences with study staff with their routine clinical care, and emphasized increased scheduling flexibility, thorough communication, non\u2010judgemental counselling and open, affirming environments (e.g. compassion, less stigma) as adherence facilitators. Injection experiences were positive overall; some described early injection\u2010related anxiety, which abated with time and when given some measure of control (e.g. pre\u2010injection countdown), and minimal injection site discomfort. Some concerns and misperceptions about injectable PrEP were reported. Barriers to adherence, across all adherence categories, included structural factors (e.g. financial constraints, travel) and competing demands (e.g. work schedules).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Respondents viewed injectable PrEP trial participation as a positive experience and a means of enhancing wellbeing. Study site flexibility and affirming clinic environments, inclusive of non\u2010judgemental counselling, were key facilitators of adherence. To support injection persistence, interventions that address structural barriers and promote flexible means of injection delivery may be most effective.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26252","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T04:15:19Z","timestamp":1716524119000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["HPTN 083\u201002: factors influencing adherence to injectable PrEP and retention in an injectable PrEP study"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0705-2239","authenticated-orcid":false,"given":"Christina","family":"Psaros","sequence":"first","affiliation":[{"name":"Department of Psychiatry Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts 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