Effectiveness of vaginal microbicides in preventing HIV transmission
JournalTropical Medicine and International Health
PublisherBlackwell Publishing Ltd
MetadataShow full item record
AbstractObjective: To evaluate the evidence on the effectiveness of vaginal microbicides in preventing HIV transmission in women. Methods: Systematic review through a comprehensive search of relevant electronic databases for eligible randomised controlled trials (RCTs) published through June 2019. Two authors independently screened titles and abstracts according to eligibility criteria, then extracted data and assessed risk of bias of included studies. We conducted a random-effects meta-analysis of risk ratios (RR) of HIV infection and assessed heterogeneity using chi-squared and I2 tests. Sources of heterogeneity were investigated through subgroup analysis, publication bias was assessed using funnel plots, and certainty of evidence was graded using GRADEPro software. Results: We included 18 RCTs which enrolled 40,048 sexually active, HIV-negative, non-pregnant women, aged 16 years and older, mainly from sub-Saharan Africa. The intravaginal ring containing dapivirine significantly reduced HIV risk by 29% (RR 0.71, 95% CI: 0.57-0.89; 2 RCTs, 4,564 women, moderate certainty of evidence). Estimates of effect of tenofovir 1% (RR 0.83, 95% CI: 0.65-1.06), nonoxynol-9 (RR 1.15, 95% CI: 0.93-1.42), cellulose sulphate (RR 1.16, 95% CI: 0.61-2.21), SAVVY (RR 1.34, 95% CI: 0.69-2.59), Carraguard (RR 0.89, 95% CI: 0.71-1.10), BufferGel (RR 1.02, 95% CI: 0.71-1.46), 0.5% PRO2000 (RR 0.88, 95% CI: 0.60-1.28) and 2% PRO2000 (RR 0.81, 95% CI: 0.58-1.12) failed to reach statistical significance; each had low certainty of evidence. Conclusion: The long-acting intravaginal ring containing dapivirine significantly reduced risk of HIV transmission in women by 29%. The remaining microbicides had no evident effect.
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85084487071&doi=10.1111%2ftmi.13401&partnerID=40&md5=9bd66d202f51f5306f2d5f474052eb23; http://hdl.handle.net/10713/12809
- Topical microbicides for prevention of sexually transmitted infections.
- Authors: Obiero J, Mwethera PG, Wiysonge CS
- Issue date: 2012 Jun 13
- Vaginal microbicides for reducing the risk of sexual acquisition of HIV infection in women: systematic review and meta-analysis.
- Authors: Obiero J, Mwethera PG, Hussey GD, Wiysonge CS
- Issue date: 2012 Nov 6
- School-based interventions for preventing HIV, sexually transmitted infections, and pregnancy in adolescents.
- Authors: Mason-Jones AJ, Sinclair D, Mathews C, Kagee A, Hillman A, Lombard C
- Issue date: 2016 Nov 8
- Clinical development of microbicides for the prevention of HIV infection.
- Authors: D'Cruz OJ, Uckun FM
- Issue date: 2004
- Mefloquine for preventing malaria in pregnant women.
- Authors: González R, Pons-Duran C, Piqueras M, Aponte JJ, Ter Kuile FO, Menéndez C
- Issue date: 2018 Mar 21