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dc.contributor.authorMusekiwa, A.
dc.contributor.authorFernando, N.B.
dc.contributor.authorAbariga, S.A.
dc.date.accessioned2020-05-26T20:41:53Z
dc.date.available2020-05-26T20:41:53Z
dc.date.issued2020
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85084487071&doi=10.1111%2ftmi.13401&partnerID=40&md5=9bd66d202f51f5306f2d5f474052eb23
dc.identifier.urihttp://hdl.handle.net/10713/12809
dc.description.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.en_US
dc.description.urihttps://doi.org/10.1111/tmi.13401en_US
dc.language.isoen_USen_US
dc.publisherBlackwell Publishing Ltden_US
dc.relation.ispartofTropical Medicine and International Health
dc.subjectdapivirineryen_US
dc.subjectHIV preventionen_US
dc.subjectmeta-analysisen_US
dc.subjectsystematic reviewen_US
dc.subjectvaginal microbicideen_US
dc.subjectvaginal ringen_US
dc.titleEffectiveness of vaginal microbicides in preventing HIV transmissionen_US
dc.typeArticleen_US
dc.identifier.doi10.1111/tmi.13401
dc.identifier.pmid32306503


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