San Francisco Chronicle (07.13.07) - Tuesday, July 17, 2007
A recent study found no additional protective effect against
HIV for women using a latex diaphragm and lubricant gel during
sex when compared with condom use alone. The three-year
randomized study enrolled about 5,000 women ages 18-49 in
Durban and Johannesburg, South Africa, and in Harare,
Zimbabwe. Average follow-up was 18 months.
Half the group received diaphragms and a lubricant, and both
groups received condoms and HIV/AIDS counseling, especially on
how to have their partners use condoms. Among the diaphragm-
condom-lubricant group, there were 158 infections, compared to
151 infections among women given condoms and counseling only.
About 4 percent became infected in each group.
The diaphragm participants admitted using the device only 70
percent of the time, surprising and disappointing researchers,
said Nancy Padian, executive director of the University of
California-San Francisco Women's Global Health Improvement.
The diaphragm group also admitted male partners used condoms
only 54 percent of the time, compared to 85 percent male
condom use for the condoms-only trial participants.
"It's very, very disappointing, of course," said Padian, the
study's leader. "We were hoping to find a protective effect.
It's taken me a long time to get over how devastating this
is." Padian said the study was not designed to assess the
protective efficacies of diaphragms compared with condoms
against HIV infection. The Bill & Melinda Gates Foundation was
a strong backer of the trial, which was meant to develop
female-controlled HIV prevention methods, as females face a
higher infection risk.
The full study, "Diaphragm and Lubricant Gel for Prevention of
HIV Acquisition in Southern African Women: A Randomized
Controlled Trial," was published online in The Lancet (2007;