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An acceptability and safety study of the Duet(® )cervical barrier and gel delivery system in Zimbabwe
BACKGROUND: Adherence problems with coitally dependent, female-initiated HIV prevention methods have contributed to several trials' failure to establish efficacy. Continuous use of a cervical barrier with once-daily cleaning and immediate reinsertion may simplify use for women and improve adher...
Autores principales: | , , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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The International AIDS Society
2010
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924266/ https://www.ncbi.nlm.nih.gov/pubmed/20687954 http://dx.doi.org/10.1186/1758-2652-13-30 |
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author | Montgomery, Elizabeth T Woodsong, Cynthia Musara, Petina Cheng, Helen Chipato, Tsungai Moench, Thomas R Spielberg, Freya van der Straten, Ariane |
author_facet | Montgomery, Elizabeth T Woodsong, Cynthia Musara, Petina Cheng, Helen Chipato, Tsungai Moench, Thomas R Spielberg, Freya van der Straten, Ariane |
author_sort | Montgomery, Elizabeth T |
collection | PubMed |
description | BACKGROUND: Adherence problems with coitally dependent, female-initiated HIV prevention methods have contributed to several trials' failure to establish efficacy. Continuous use of a cervical barrier with once-daily cleaning and immediate reinsertion may simplify use for women and improve adherence. We assessed the acceptability and safety of precoital and continuous use of the Duet(®), a cervical barrier and gel delivery system, in Zimbabwean women. METHODS: Using a two-arm crossover design with a parallel observation group, we randomized 103 women in a 2:2:1 ratio: (1) to use the Duet continuously for 14 days, followed by a minimum of seven days of washout and then 14 days of precoital use; (2) to use the same Duet regimens in reverse order; or (3) for observation only. Women were aged 18 to 40 years; half were recruited from a pool of previous diaphragm study participants and the other half from the general community. Acceptability and adherence were assessed through an interviewer-administered questionnaire at each of two follow-up visits. Safety was monitored through pelvic speculum exams and report of adverse events. RESULTS: The proportion of women who reported consistent Duet use during sex was virtually identical during continuous and precoital regimens (88.6% vs. 88.9%). Partner refusal was the most common reason cited for non-use during sex in both use regimens. Not having the device handy was the most common reason cited for non-daily use (in the continuous regimen). Most women were "very comfortable" using it continuously (86.3%) and inserting it precoitally (92.8%). The most favoured Duet attribute was that it did not interfere with "natural" sex (55%). The least favoured Duet attribute was the concern that it might come out during sex (71.3%). No serious adverse events were reported during the study; 57 participants reported 90 adverse events classified as mild or moderate. There were no statistically significant differences in: (1) the proportion of women reporting adverse events; (2) the severity of events among those using the Duet and observational controls; or (3) event severity reported during each regimen use period. CONCLUSIONS: In this study, the Duet was found to be acceptable and safe when inserted precoitally or used continuously for 14 days. Assignment to use of the Duet continuously did not increase adherence to the Duet during sex. Future HIV prevention trials should evaluate use of the Duet (precoitally and continuously) with promising microbicide candidates. |
format | Text |
id | pubmed-2924266 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | The International AIDS Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-29242662010-08-20 An acceptability and safety study of the Duet(® )cervical barrier and gel delivery system in Zimbabwe Montgomery, Elizabeth T Woodsong, Cynthia Musara, Petina Cheng, Helen Chipato, Tsungai Moench, Thomas R Spielberg, Freya van der Straten, Ariane J Int AIDS Soc Research BACKGROUND: Adherence problems with coitally dependent, female-initiated HIV prevention methods have contributed to several trials' failure to establish efficacy. Continuous use of a cervical barrier with once-daily cleaning and immediate reinsertion may simplify use for women and improve adherence. We assessed the acceptability and safety of precoital and continuous use of the Duet(®), a cervical barrier and gel delivery system, in Zimbabwean women. METHODS: Using a two-arm crossover design with a parallel observation group, we randomized 103 women in a 2:2:1 ratio: (1) to use the Duet continuously for 14 days, followed by a minimum of seven days of washout and then 14 days of precoital use; (2) to use the same Duet regimens in reverse order; or (3) for observation only. Women were aged 18 to 40 years; half were recruited from a pool of previous diaphragm study participants and the other half from the general community. Acceptability and adherence were assessed through an interviewer-administered questionnaire at each of two follow-up visits. Safety was monitored through pelvic speculum exams and report of adverse events. RESULTS: The proportion of women who reported consistent Duet use during sex was virtually identical during continuous and precoital regimens (88.6% vs. 88.9%). Partner refusal was the most common reason cited for non-use during sex in both use regimens. Not having the device handy was the most common reason cited for non-daily use (in the continuous regimen). Most women were "very comfortable" using it continuously (86.3%) and inserting it precoitally (92.8%). The most favoured Duet attribute was that it did not interfere with "natural" sex (55%). The least favoured Duet attribute was the concern that it might come out during sex (71.3%). No serious adverse events were reported during the study; 57 participants reported 90 adverse events classified as mild or moderate. There were no statistically significant differences in: (1) the proportion of women reporting adverse events; (2) the severity of events among those using the Duet and observational controls; or (3) event severity reported during each regimen use period. CONCLUSIONS: In this study, the Duet was found to be acceptable and safe when inserted precoitally or used continuously for 14 days. Assignment to use of the Duet continuously did not increase adherence to the Duet during sex. Future HIV prevention trials should evaluate use of the Duet (precoitally and continuously) with promising microbicide candidates. The International AIDS Society 2010-08-05 /pmc/articles/PMC2924266/ /pubmed/20687954 http://dx.doi.org/10.1186/1758-2652-13-30 Text en Copyright © 2010 Montgomery et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Montgomery, Elizabeth T Woodsong, Cynthia Musara, Petina Cheng, Helen Chipato, Tsungai Moench, Thomas R Spielberg, Freya van der Straten, Ariane An acceptability and safety study of the Duet(® )cervical barrier and gel delivery system in Zimbabwe |
title | An acceptability and safety study of the Duet(® )cervical barrier and gel delivery system in Zimbabwe |
title_full | An acceptability and safety study of the Duet(® )cervical barrier and gel delivery system in Zimbabwe |
title_fullStr | An acceptability and safety study of the Duet(® )cervical barrier and gel delivery system in Zimbabwe |
title_full_unstemmed | An acceptability and safety study of the Duet(® )cervical barrier and gel delivery system in Zimbabwe |
title_short | An acceptability and safety study of the Duet(® )cervical barrier and gel delivery system in Zimbabwe |
title_sort | acceptability and safety study of the duet(® )cervical barrier and gel delivery system in zimbabwe |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924266/ https://www.ncbi.nlm.nih.gov/pubmed/20687954 http://dx.doi.org/10.1186/1758-2652-13-30 |
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