{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T21:18:33Z","timestamp":1780607913379,"version":"3.54.1"},"reference-count":30,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["7200AA21CA00011"],"award-info":[{"award-number":["7200AA21CA00011"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Eswatini prepared for the national rollout of HIV pre\u2010exposure prophylaxis (PrEP) choice through a mixed\u2010method demonstration study introducing the PrEP dapivirine vaginal ring in 12 Ministry of Health\u2010supported sites. The Eswatini PrEP Ring Study aimed to describe user preferences for, and experiences with, the PrEP ring, and provider impressions. The objective was to provide real\u2010world data on client preferences and experiences related to PrEP choice, and healthcare provider perspectives on the feasibility and acceptability of offering PrEP choice. A subset of quantitative findings is presented here.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>During May 2023\u2013August 2024, 12 study sites in Eswatini began offering a choice between the PrEP ring and oral PrEP to women 18 years and older who were HIV negative, not pregnant or breastfeeding, and interested in PrEP. Current oral PrEP users who were satisfied with the method were not recruited. Users\u2019 early experiences with the PrEP ring were assessed through structured enrolment and follow\u2010up questionnaires. Factors associated with choosing the PrEP ring at enrolment were assessed using logistic regression. During the first 2 months of offering PrEP choice, providers (<jats:italic>n<\/jats:italic> = 16) completed a structured questionnaire on the feasibility and acceptability of PrEP choice service delivery. Clinical Trial Number: NCT05889533<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At enrolment, 69% (<jats:italic>n<\/jats:italic> = 625\/904) chose the PrEP ring. Predictors for choosing the ring included ages 25+ (25\u201334 years AOR = 1.44, 95% CI [1.03, 2.02]; ages 35+ years AOR = 1.69, 95% CI [1.07, 2.68]), higher education (AOR = 1.71 for some\/completed high school, 95% CI [1.20, 2.43]; AOR = 1.87 for vocational\/tertiary education, 95% CI [1.21, 2.90]) and using either longer\u2010acting (AOR = 2.23, 95% CI [1.28, 3.89]) or shorter\u2010acting contraceptives (AOR = 1.63, 95% CI [1.14, 2.32]) versus no modern family planning method. Participants reported high levels of ease and confidence (98%) in using the ring. Ninety\u2010four percent of PrEP counsellors (<jats:italic>n<\/jats:italic> = 8) and nurses (<jats:italic>n<\/jats:italic> = 8) felt prepared to offer PrEP choice and liked choice counselling but had concerns about clients\u2019 ability to return on time for refills of either method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Many women in Eswatini were willing to try the PrEP ring. Providers were enthusiastic about counselling on PrEP choice and introducing women to the ring.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26490","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T07:31:56Z","timestamp":1751441516000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["User and healthcare provider early experiences with the PrEP ring: a quantitative study on the introduction of a new PrEP method in Eswatini"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9764-2178","authenticated-orcid":false,"given":"Anita","family":"Hettema","sequence":"first","affiliation":[{"name":"FHI 360  Mbabane Eswatini"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siphesihle","family":"Shongwe","sequence":"additional","affiliation":[{"name":"FHI 360  Mbabane Eswatini"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haley","family":"Sisel","sequence":"additional","affiliation":[{"name":"FHI 360  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mxolisi","family":"Khumalo","sequence":"additional","affiliation":[{"name":"FHI 360  Mbabane Eswatini"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ncediso","family":"Gama","sequence":"additional","affiliation":[{"name":"FHI 360  Mbabane Eswatini"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nolwazi","family":"Khanyile","sequence":"additional","affiliation":[{"name":"FHI 360  Mbabane Eswatini"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Buyile","family":"Mahlalela","sequence":"additional","affiliation":[{"name":"FHI 360  Mbabane Eswatini"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sindy Nana","family":"Matse","sequence":"additional","affiliation":[{"name":"Ministry of Health  Mbabane Eswatini"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7075-3003","authenticated-orcid":false,"given":"Jill M.","family":"Peterson","sequence":"additional","affiliation":[{"name":"FHI 360  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,2]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"KamyaMR BalzerLB AyiekoJ KabamiJ KakandeE ChamieG et\u00a0al.Randomized trial of SEARCH dynamic choice HIV prevention including injectable cabotegravir (CAB\u2010LA).Conference on Retroviruses and Opportunistic Infections (CROI); March 3\u20136 2024;Denver CO;2024."},{"key":"e_1_2_12_3_1","unstructured":"World Health Organization.Guidelines: updated recommendations on HIV prevention infant diagnosis antiretroviral initiation and monitoring.2021."},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(14)70937-5"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000172"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(20)30304-0"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602046"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy909"},{"key":"e_1_2_12_9_1","unstructured":"ViivHealthcare.Improving access to HIV medicines. 2025. 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