Hey came to believe they were assigned FTC/TDF and it was working. However, neither participant provided an explanation (Note: order Pinometostat participants referred to FTC/TDF by its trade name Truvada.): So we joined because we knew we had other sexual partners and we wanted to see if this drug could work in protecting us from getting HIV. And so we used this pill and by the time we were six months in the study, we knew we were Actinomycin IVMedChemExpress Actinomycin D taking Truvada and it is preventing HIV infection. (Bondo, moderate group)Adherence counseling. Five participants in the high adherence group and 12 in the moderate group spoke about their motivation to adhere after adherence counseling. Seven of these participants simply gave general, non-descriptive “encouragement” statements about their motivation to adhere after participating in adherence counseling. The narratives of the remaining participants did not focus on the helpfulness of the pill-taking strategies discussed in adherence counseling, such as brainstorming about potential strategies to overcome any barriers they may have faced in taking the pill. Rather, they focused on two factors that were strengthened by adherence counseling: 1) a sense of reassurance that staff can help them in case they experience any side effects (n = 5) and 2) their dedication to contribute to answering the research question (n = 6): Mostly if we go there the [counselor] talks to you. I feel that I regain my heart [Interviewer note: getting motivated] because how they put it to test to know if that thing works. (Bondo, moderate group)Routine formation and use of tools. Twelve participants in the high adherence group and 13 in the moderate group explained that they remembered to take the study pill because they integrated daily pill taking into their everyday lives by establishing a routine, they usedPLOS ONE | DOI:10.1371/journal.pone.0125458 April 13,10 /Facilitators of Study Pill Adherence in FEM-PrEPadherence reminder tools, or they became “used to” taking the pills regularly. Establishing a daily time to take the study pill–usually linked to another activity such as going to bed, waking up in the morning, or doing chores–was the most common adherence strategy described for remembering to take the study pill (n = 17): So for me [at the beginning of the study when I took the pills], the time I chose really helped me because I had mastered it. I could wake up at 5 a.m. and take it. That is when I could start doing my chores. (Bondo, moderate group) Setting a reminder alarm, with or without the use of other strategies, was also frequently mentioned (n = 8): I used to set [my phone alarm] at 8:00 every day. Like I never forgot. At night. Even if the phone rings and maybe I don’t hear it, I know that when it’s time for Generations [Interviewer note: A soap opera on weekday nights]. I know it’s my time to drink pills. Then I fetch water, sit down and drink. (Pretoria, high group) Several participants (n = 6) also spoke about keeping the pills with them or keeping them visible, such as on a table near their bed, so they could see them every day: I kept those pills where I could see them. Now anytime I was ready to go to sleep, I could see them and then I remembered. Then I did what? I took them. Anytime I was going to sleep I could see them, because I was taking them when I [was] going to sleep. (Bondo, high group) Only four participants mentioned that using the study-provided pill box (n = 3) or calendar (n = 1) helped them to adhere. Partner aw.Hey came to believe they were assigned FTC/TDF and it was working. However, neither participant provided an explanation (Note: participants referred to FTC/TDF by its trade name Truvada.): So we joined because we knew we had other sexual partners and we wanted to see if this drug could work in protecting us from getting HIV. And so we used this pill and by the time we were six months in the study, we knew we were taking Truvada and it is preventing HIV infection. (Bondo, moderate group)Adherence counseling. Five participants in the high adherence group and 12 in the moderate group spoke about their motivation to adhere after adherence counseling. Seven of these participants simply gave general, non-descriptive “encouragement” statements about their motivation to adhere after participating in adherence counseling. The narratives of the remaining participants did not focus on the helpfulness of the pill-taking strategies discussed in adherence counseling, such as brainstorming about potential strategies to overcome any barriers they may have faced in taking the pill. Rather, they focused on two factors that were strengthened by adherence counseling: 1) a sense of reassurance that staff can help them in case they experience any side effects (n = 5) and 2) their dedication to contribute to answering the research question (n = 6): Mostly if we go there the [counselor] talks to you. I feel that I regain my heart [Interviewer note: getting motivated] because how they put it to test to know if that thing works. (Bondo, moderate group)Routine formation and use of tools. Twelve participants in the high adherence group and 13 in the moderate group explained that they remembered to take the study pill because they integrated daily pill taking into their everyday lives by establishing a routine, they usedPLOS ONE | DOI:10.1371/journal.pone.0125458 April 13,10 /Facilitators of Study Pill Adherence in FEM-PrEPadherence reminder tools, or they became “used to” taking the pills regularly. Establishing a daily time to take the study pill–usually linked to another activity such as going to bed, waking up in the morning, or doing chores–was the most common adherence strategy described for remembering to take the study pill (n = 17): So for me [at the beginning of the study when I took the pills], the time I chose really helped me because I had mastered it. I could wake up at 5 a.m. and take it. That is when I could start doing my chores. (Bondo, moderate group) Setting a reminder alarm, with or without the use of other strategies, was also frequently mentioned (n = 8): I used to set [my phone alarm] at 8:00 every day. Like I never forgot. At night. Even if the phone rings and maybe I don’t hear it, I know that when it’s time for Generations [Interviewer note: A soap opera on weekday nights]. I know it’s my time to drink pills. Then I fetch water, sit down and drink. (Pretoria, high group) Several participants (n = 6) also spoke about keeping the pills with them or keeping them visible, such as on a table near their bed, so they could see them every day: I kept those pills where I could see them. Now anytime I was ready to go to sleep, I could see them and then I remembered. Then I did what? I took them. Anytime I was going to sleep I could see them, because I was taking them when I [was] going to sleep. (Bondo, high group) Only four participants mentioned that using the study-provided pill box (n = 3) or calendar (n = 1) helped them to adhere. Partner aw.
