Once recruited and retained, it is essential that study participants adhere to the prevention protocol if the full effectiveness of the intervention is to be captured. For some technologies and in some social and familial circumstances, this may prove impossible for study participants. If significant numbers of participants have less than optimal adherence, the study and its outcomes may be compromised. Counselling about the importance of adherence is an essential but labour-intensive and costly component of HIV prevention trials (142, 143).
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