• AIDS and behavior · Jun 2009

    Randomized Controlled Trial

    The use of the diaphragm instead of condoms in a phase III diaphragm trial.

    • Ariane van der Straten, Helen Cheng, Jie Moore, Deborah Kacanek, Kelly Blanchard, Guy De Bruyn, Gita Ramjee, Tsungai Chipato, Elizabeth T Montgomery, Nancy Padian, and MIRA Team.
    • Women's Global Health Imperative, RTI International, 114 Sansome Street, Suite 500, San Francisco, CA 94104, USA. ariane@rti.org
    • AIDS Behav. 2009 Jun 1; 13 (3): 564-72.

    AbstractThe MIRA trial assessed whether providing diaphragm, lubricant gel, and condoms (intervention) compared with condoms alone (control) could reduce HIV incidence among 5,039 Southern African women. Compared with the control group, the cumulative proportion of last sex acts protected by any method was higher in the intervention group (OR = 1.33; 95% CI 1.18, 1.49); however, only 36.3% of last sex acts were protected by both a male condom and a diaphragm, whereas 36.6% were protected by a diaphragm only. Product substitution (ever deciding to use a diaphragm instead of a condom in the previous 3 months) was reported at every visit by 22.4%, at some visits by 60.7%, and at none of the visits by 16.8% of these women. Women at greater risk for infection through their own or their partner's behavior or who believed the diaphragm protected against HIV were more likely to report product substitution at every visit.

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