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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Efficacy of Nonoxynol 9 Contraceptive Sponge Use in Preventing Heterosexual Acquisition of HIV in Nairobi Prostitutes
JAMA: The Journal of the American Medical Association, Volume 268, No. 4, Year 1992
Notification
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Description
Objective.—To determine the efficacy of the nonoxynol 9 contraceptive sponge in preventing sexual acquisition of the human immunodeficiency virus (HIV). Design.—Prospective, randomized placebo-controlled trial. Setting.—Research clinic for prostitutes in Nairobi, Kenya. Patients and Interventions.—One hundred thirty-eight HIV-seronegative women were enrolled, of whom 74 were assigned to nonoxynol 9 sponge use and 64 to placebo use. These two groups did not significantly differ with respect to demographic characteristics, sexual practices, or prevalence of genital infections at enrollment, except for a lower number of sex partners per week and a higher initial prevalence of genital ulcers among women assigned to nonoxynol 9 sponge use. Among the 116 women who returned for follow-up, the mean durations of follow-up were 14 and 17 months for the two groups, respectively. Main Outcome Measure.—HIV seroconversion. Results.—Nonoxynol 9 sponge use was associated with an increased frequency of genital ulcers (relative risk [RR], 3.3; P<.0001) and vulvitis (RR, 3.3; P<.0001) and a reduced risk of gonococcal cervicitis (RR, 0.4; P<.0001). Twenty-seven (45%) of 60 women in the nonoxynol 9 sponge group and 20 (36%) of 56 women in the placebo group developed HIV antibodies. The hazard ratio for the association between nonoxynol 9 sponge use and HIV seroconversion was 1.7 (95% confidence interval [CI], 0.9 to 3.0). Using multivariate analysis to control for the presence of genital ulcers at enrollment, the adjusted hazard ratio for the association between nonoxynol 9 sponge use and seroconversion was 1.6 (95% CI, 0.8 to 2.8). Conclusions.—Genital ulcers and vulvitis occurred with increased frequency in nonoxynol 9 sponge users. We were unable to demonstrate that nonoxynol 9 sponge use was effective in reducing the risk of HIV infection among highly exposed women. © 1992, American Medical Association. All rights reserved.
Authors & Co-Authors
Kreiss, Joan K.
United States, Seattle
University of Washington
Ngugi, Elizabeth N.
Kenya, Nairobi
University of Nairobi
Holmes, King K.
United States, Seattle
University of Washington
Ndinya-Achola, Jeckoniah O.
Kenya, Nairobi
University of Nairobi
Waiyaki, Peter G.
Kenya, Nairobi
Kenya Medical Research Institute
Roberts, Pacita L.
United States, Seattle
University of Washington
Ruminjo, Irene
Kenya, Nairobi
University of Nairobi
Sajabi, Rose Miroyo
Kenya, Nairobi
University of Nairobi
Kimata, Joyce
Kenya, Nairobi
Kenya Medical Research Institute
Fleming, Thomas R.
United States, Seattle
University of Washington
Anzala, Aggrey Omu
Kenya, Nairobi
University of Nairobi
Holton, Donna
Canada, Winnipeg
University of Manitoba
Plummer, Francis Allan
Canada, Winnipeg
University of Manitoba
Statistics
Citations: 402
Authors: 13
Affiliations: 4
Identifiers
Doi:
10.1001/jama.1992.03490040053025
ISSN:
00987484
e-ISSN:
15383598
Research Areas
Environmental
Health System And Policy
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Kenya
Participants Gender
Female