Adherence to the Dapivirine Vaginal Ring Among Cisgender Women in Africa: Protocol for a Systematic Review and Meta‐Analysis
Bibliographic record
Abstract
Background and Aims: Despite the availability of HIV preventive measures, new HIV infections are still on the rise. The Dapivirine Vaginal Ring (DVR) is a silicone circular ring that continuously distributes 25 mg of Dapivirine into a woman's vagina for 28 days to prevent HIV infection; however, the effectiveness of DVR is largely dependent on adherence. To date, adherence to DVR has not been aggregated and summarized. The objective of this systematic review is to summarize the evidence on adherence to DVR for HIV-1 prevention among African women and to aggregate findings into a quantitative estimate. Methods: We will conduct a systematic review of studies in which DVR has been used to prevent HIV-1 in African women. We will search MEDLINE, Global Health, CINAHL, and EMBASE from database inception to December 2024. We will include observational studies and randomized trials of women between 15 and 49 years of age, resident in Africa, who have used the DVR. Our primary outcome will be adherence to DVR. Pairs of reviewers will independently screen for eligible studies and will extract relevant data. We will perform a random-effects meta-analysis for DVR adherence. Certainty of the evidence will be assessed using the GRADE approach. Discussion: This systematic review and meta-analysis will contribute to a better understanding of how DVR adherence aids in preventing HIV-1 infection in women, as well as the factors that influence observed adherence. Its findings can provide important foundational knowledge for future research and innovation in DVR and other PrEP tools. Findings from this protocol article will be disseminated as peer-reviewed publications, at conferences, and as part of a master's thesis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.054 | 0.070 |
| Meta-epidemiology (narrow) | 0.005 | 0.004 |
| Meta-epidemiology (broad) | 0.020 | 0.029 |
| Bibliometrics | 0.009 | 0.009 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.006 | 0.006 |
| Open science | 0.005 | 0.004 |
| Research integrity | 0.006 | 0.006 |
| Insufficient payload (model declined to judge) | 0.048 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".