Effects of Partnership Change on Microbicide Gel Adherence in a Clinical Trial (HPTN 035)
- 197 Downloads
Use of HIV prevention methods may vary for women by types of sexual partners. In a microbicide safety and effectiveness trial (HPTN 035) differences in adherence to a microbicide study gel were compared between women with new versus ongoing partnerships over time. 1,757 women in the three HPTN 035 trial’s arms completed the Follow-up Partner Status (FPS) questionnaire at their last study visit. Women married at baseline were asked if they had the same husband, new husband or new partner. Unmarried women were asked if they had changed partners or married. Self-reported gel adherence during the last sex act was compared at each quarterly visit between women with ongoing versus new partners. High gel adherence was compared with low gel adherence (85–100 vs. <85 % of last vaginal sex acts reported with gel use, respectively) in multivariable models to assess associations with partner change. Overall 7 % of women (n = 123) reported a new partner and 41 % (51) of those reported a new husband. Median gel adherence was reported to be 100 % in women with ongoing partners and 75 % for women with new partners (p < 0.001). In women reporting no gel use in their last sex act, only 12.5 % of the women with a new partner and none of those with an ongoing partner reported using condoms (p < 0.001). Fewer women with new partners reported using both the gel and condom during the last sex act as compared to women with ongoing partners (median 50 vs. 71.4 %, p < 0.001). After adjusting for age, site, education level, and sexual frequency, women with ongoing partners were more likely to report high gel adherence than those with new partners (AOR 2.5, 95 % CI 1.6, 3.9). This pattern persisted when gel use over time was compared between women with new versus ongoing partners. In the HPTN 035 trial, women with new partners had higher HIV incidence and reported less gel use and higher condom use. Specific counseling and support are needed to help women use potential HIV prevention methods, including microbicides, when they are changing partners.
KeywordsAdherence Microbicide HIV Partner status
HPTN 035 was funded by the US National Institutes of Health and designed and implemented by the HPTN and the MTN. HPTN (U01AI46749) has been funded by the National Institute of Allergy and infectious Diseases (NIAID), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institute of Drug Abuse, and National Institute of Mental Health (NIMH). MTN (U01AI068633) has been funded by NIAID, NICHD, and NIMH.
- 3.Baeten J, Donnell D, Ndase P, et al. ARV PrEP for HIV-1 prevention among heterosexual men and women. . 19th Conference on Retroviruses and Opportunistic Infections (CROI). Seattle 2012.Google Scholar
- 4.Van Damme L, CorneliA, Ahmed K, et al. The FEM-PrEP trial of emtricitabine/tenofovir disoproxil fumarate (Truvada) among African women. Paper presented at: Conference on Retroviruses and Opportunistic Infections (CROI); 5–8 March, Seattle 2012.Google Scholar
- 9.Onoya D, Reddy P, Sifunda S, et al. Transactional sexual relationships, sexually transmitted infection risk, and condom use among young Black Women in peri-urban areas of the Western Cape Province of South Africa. Women’s health issues : official publication of the Jacobs Institute of. Women’s Health. May-Jun. 2012;22(3):e277–82.Google Scholar
- 16.Marrazzo Jea. Pre-exposure prophylaxis for HIV in women: daily oral tenofovir, oral tenofovir/emtricitabine, or vaginal tenofovir gel in the VOICE study (MTN 003). . 20th Conference on Retroviruses and Opportunistic Infections. Atlanta. 2013.Google Scholar
- 19.Van Damme LCA, Ahmed K, Van Damme L, Corneli A, Ahmed K, Agot K, Lombaard J, Kapiga S, Malahleha M, Owino F, Manongi R, Onyango J, Temu L, Monedi MC, Mak’Oketch P, Makanda M, Reblin I, Makatu SE, Saylor L, Kiernan H, Kirkendale S, Wong C, Grant R, Kashuba A, Nanda K, Mandala J, Fransen K, Deese J, Crucitti T, Mastro TD, Taylor D, FEM-PrEP Study Group. Preexposure prophylaxis for HIV infection among African women. N Engl J Med. 2012;367(5):411–22.PubMedCentralPubMedCrossRefGoogle Scholar