Drawing primarily from data and experience from large-scale microbicide efficacy trials, this article published in the Journal of the International AIDS Society identifies lessons learned about adherence to study regimens in six areas: 1) adherence measurement in clinical trials, 2) comprehension of use instructions/instructions for use, 3) unknown efficacy and its effect on adherence/messages regarding effectiveness, 4) partner influence on use, 5) retention and continuation, and 6) the generalizability of trial participants' adherence behavior.