AEGiS-14IAC: Will shifts from condom to microbicide use increase HIV risk? Model projections.

14th International AIDS Conference


Barcelona, Spain - July 7-12, 2002

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Will shifts from condom to microbicide use increase HIV risk? Model projections.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. WeOrD1319)

Foss AM, Vickerman P, Heise L, Watts C
London School of Hygiene &Tropical Medicine, London, United Kingdom

BACKGROUND Currently there are six microbicide candidates nearing phase III trials. There are concerns, however, that the introduction of microbicides might lead to women using condoms less consistently (condom migration). This study estimates the level of condom migration that could occur following microbicide introduction without increasing an individual's risk of HIV infection (migration threshold). METHODS A static mathematical model was developed to compare the relative levels of protection from HIV provided by different combinations of condom and microbicide use and to obtain the migration threshold. RESULTS Microbicides will always provide more protection than condoms if the initial consistency of condom use is less than the product of the consistency that microbicides will be used and the relative efficacy of microbicides to condoms. Maximum threshold level of condom migration that can occur after microbicide

INTRODUCTION: [table: see text] Assuming microbicide is of 50% HIV and STD efficacy, and condoms are 95% efficacious. For a microbicide that is efficacious against both HIV and other STDs, the migration threshold is: * - greater for higher microbicide efficacies and consistencies; * - greater for lower pre-introduction condom-consistencies; * - independent of the number of sexual partners and acts, and HIV and STD prevalence. For further illustration, suppose the condom-consistency pre-introduction is less than 50%, then any amount of migration can be tolerated if microbicides are used whenever condoms are not. CONCLUSIONS The findings provide a quantitative estimate of the degree of migration that can be tolerated in different settings. The analysis highlights the importance of microbicides for HIV prevention. Further research will explore the dynamic impact of microbicide use and condom migration.

Keywords: AEGIS, Condoms, Anti-Infective Agents, Safe Sex, HIV Infections, Sexual Partners, HIV Seropositivity, Acquired Immunodeficiency Syndrome, Condoms, Female, Human, FemaleKWDaegis,condoms,anti-infectiveagents,safesex,hivinfections,sexualpartners,hivseropositivity,acquiredimmunodeficiencysyndrome,condoms,female,human,female

020707
WeOrD1319

Copyright © 2002 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.