Background
douche, human immunodeficiency virus (HIV), MSM
STIS, SEXUALLY TRANSMITTED INFECTIONS
In the past 30 years, there have been significant strides to prevent and treat human immunodeficiency virus (HIV). In 2021, there were 38.4 million people across the world living with HIV [Rectal microbicides (RM) are biomedical products applied inside the rectum with the goal of preventing or reducing HIV and other sexually transmitted infections (STIs) [Alongside the biomedical properties of a drug candidate, the modality through which it is delivered is central to promoting its optimal acceptability and adherence. Within the existing RM literature, there is large variability in responses to product acceptability and adherence. Global behavioral research with MSM and transgender populations has found high hypothetical acceptability of a RM formulated as a douche, insert, or suppository [The goal of this study was to understand how MSM and transgender people enrolled in MTN-035 reported their acceptability of and adherence to each of the three products based on weekly self-reports during each 4-week study product use period. We examined whether participants’ use of each placebo modality (douche, insert, and suppository) changed over time. Given prior research noting the presence of diverse trajectories [