Table 2.

Outline of Participant-Centered Adherence Counseling Sessions

Enrollment Visit
1.	Welcome participant to the session and affirm attendance.
2.	Provide overview of what will occur during counseling sessions.
3.	Clarify counselor’s role, emphasize respect for the participant’s choice about Dapivirine Vaginal Ring use and a collaborative, non-judgmental approach.
4.	Explore participant’s motivations for joining HOPE.
5.	Explore knowledge of ASPIRE results to ensure the participant is well informed before she makes any decisions about Dapivirine Vaginal Ring use.
6.	Inquire if participant is interested in using the Dapivirine Vaginal Ring and/or another HIV prevention method.
7.	Explore participant’s decision to use/not use the ring. Help participant develop a plan for using the Dapivirine Vaginal Ring consistently, if applicable.
8.	Explore participant’s decision to use other HIV prevention approaches. Help her to develop a plan for using them consistently, if applicable.
9.	Assess importance and confidence in implementing selected approaches in the participant’s life.
10.	Provide participant with an opportunity to share any remaining questions/concerns.
11.	Wrap-up by affirming attendance and giving a brief overview of the next visit.
Follow-Up Visits: Months 1, 2, 3, 6, and 9
1.	Welcome participant, affirm attendance, normalize potential difficulties in implementing HIV prevention methods, provide brief overview of the session.
2.	Present information on what drug level results mean and how they pertain to protection against HIV (only if participant chose the Dapivirine Vaginal Ring).
3.	BEGINNING AT MONTH 3: Remind participant about purpose of sharing residual drug levels (only if participant chose the Dapivirine Vaginal Ring) to reduce defensiveness.
4.	BEGINNING AT MONTH 3: Share Ring drug level results to gauge the level of protection participant received from the Dapivirine Vaginal Ring.
5.	Explore how participant is doing with her HIV prevention plan, identifying barriers and facilitators to each of her selected methods.
6.	Assess how participant is feeling about her HIV prevention choices. Open a discussion about what she’d like to do with her plan going forward.
7.	Problem-solve ways to maintain or improve the participant’s HIV prevention plan that are in-line with the participant’s goals and desires.
8.	Assess and problem-solve any potential obstacles that might affect participant’s HIV prevention plan.
9.	Assess confidence in implementing HIV prevention plan consistently.
10.	Provide participant with an opportunity to share any remaining questions/concerns.
11.	Wrap-up by affirming attendance and giving a brief overview of the next visit.
End Visit: Month 12
1.	Welcome participant, affirm attendance and commitment to finishing the study, and give a brief overview of the session.
2.	Review meaning of Drug Level results.
3.	Review purpose of sharing residual Drug Levels.
4.	Share Dapivirine Vaginal Ring Drug Level results.
5.	Explore how participant is doing with her HIV prevention plan to inform future plans. Identify barriers and facilitators to each method and prompt her to think about how she could overcome similar obstacles going forward.
6.	Develop an HIV prevention plan for the future, keeping in mind what has worked best for the participant throughout the HOPE study.
7.	Assess confidence in remaining HIV negative.
8.	Provide participant with an opportunity to share any remaining questions/concerns.
9.	Acknowledge and affirm participant’s contribution to the study. Express gratitude for her continued commitment and openness.