Zimbabwean women very willing to use diaphragms-potential HIV prevention method

July 09, 2002

Almost all (98 percent) Zimbabwean women who were unable to persuade their male partners to use condoms consistently, used the diaphragm as an alternative method of contraception and disease prevention, though its effectiveness against HIV remains unknown, UCSF researchers have found.

"There is substantial evidence to suggest that protecting the cervix could offer some protection against HIV, but attempts to study physical barriers that protect the cervix such as diaphragms have been stymied by the issue of acceptability. Western researchers simply have not believed that women will use them. Now that we know that they are acceptable, diaphragms need to be tested for efficacy in preventing HIV," said co-author Tsungai Chipato, MD, University of Zimbabwe professor of obstetrics and gynecology at the UZ -UCSF Collaborative Research Programme in Women's Health.

Chipato is presenting the findings at the XIV International AIDS Conference in Barcelona, Spain.

"The cervix appears to be a "hot spot" in terms of susceptibility to HIV. It is very thin and fragile and has more cells with HIV specific receptor sites than the vagina. Also, the peristalic contractions of the uterus actually draw fluids up into the upper genital track-an area that is very susceptible to HIV and other sexually transmitted diseases (STDs). This rapid upward movement of fluid is thought to enhance fertility but also transports HIV and STD causing pathogens," said the study's principal investigator, Nancy Padian, PhD, UCSF professor of obstetrics, gynecology and reproductive services and director of international programs at UCSF's AIDS Research Institute.

Data from observational studies show that protecting the cervix protects against bacterial STDs, and these STDs are proven to facilitate transmission of HIV. Also, diaphragms, which can also be vehicles to hold spermicides, may thus increase the effectiveness of new microbicides that are designed to prevent HIV acquisition, Padian said. "Given the urgent need for HIV prevention methods that a women can use without her partner knowing about or needing to consent to use, the potential of this existing product can no longer languish unexplored," said Padian, who is also director of the Women's Global Health Imperative at UCSF.

The study-which took place in Zimbabwe where thirty percent of the population is estimated to be HIV-infected-first enrolled women in a two month program to teach and encourage male condom use. Women who were unable to negotiate consistent condom use by their male partners were then enrolled into the diaphragm acceptability phase. One hundred and fifty-six women took part in the study which is ongoing. Ninety-seven percent are married and seventy percent have had only one partner in their life. Before entering the study, only one percent had ever used a diaphragm. KY jelly was used in addition to diaphragms by almost all of the women.
Co-authors of the study are Ariane van der Straten, PhD, academic coordinator at UCSF's department of obstetrics and gynecology; Samuel F. Posner, PhD, at the Centers for Disease Control (CDC); Owen Mapfumo, MA, project coordinator, Gertrude Khumalo-Sakutukwa, MSc(Medicine), senior social scientist, both at the University of Zimbabwe-UCSF Collaborative Research Programme in Women's Health, Harare, Zimbabwe; and Marianne Callahan, PhD, at the Contraceptive Research and Development Program, (CONRAD) Arlington, Virginia.

The study was funded by grants from the CDC and CONRAD.

University of California - San Francisco

Related HIV Articles from Brightsurf:

BEAT-HIV Delaney collaboratory issues recommendations measuring persistent HIV reservoirs
Spearheaded by Wistar scientists, top worldwide HIV researchers from the BEAT-HIV Martin Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) compiled the first comprehensive set of recommendations on how to best measure the size of persistent HIV reservoirs during cure-directed clinical studies.

The Lancet HIV: Study suggests a second patient has been cured of HIV
A study of the second HIV patient to undergo successful stem cell transplantation from donors with a HIV-resistant gene, finds that there was no active viral infection in the patient's blood 30 months after they stopped anti-retroviral therapy, according to a case report published in The Lancet HIV journal and presented at CROI (Conference on Retroviruses and Opportunistic Infections).

Children with HIV score below HIV-negative peers in cognitive, motor function tests
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases.

Efforts to end the HIV epidemic must not ignore people already living with HIV
Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, NIH experts assert in the third of a series of JAMA commentaries.

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.

The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.

Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.

NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.

Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.

Read More: HIV News and HIV Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.