Evidence map›Paper›PMID 23472071›Full record

Trial reportPloS one2013

Women with pregnancies had lower adherence to 1% tenofovir vaginal gel as HIV preexposure prophylaxis in CAPRISA 004, a phase IIB randomized-controlled trial.

Lynn T Matthews, Sengeziwe Sibeko, Leila E Mansoor, Nonhlanhla Yende-Zuma, David R Bangsberg, Quarraisha Abdool Karim

Registry-linked trialOpen access · goldAbstract readClinical Trial, Phase IIRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00441298 (Phase IIb Trial to Assess the Safety and Effectiveness of the Vaginal Microbicide 1% Tenofovir Gel for the Prevention of HIV Infection in Women in South Africa), which is not on this map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00441298 phase2completednot on this map

Phase IIb Trial to Assess the Safety and Effectiveness of the Vaginal Microbicide 1% Tenofovir Gel for the Prevention of HIV Infection in Women in South Africa

TypeinterventionalSponsorCentre for the AIDS Programme of Research in South AfricaRan2007 to 2010Enrolled889ConditionsHIV InfectionsArmsTenofovir gel, Placebo (Universal HEC placebo)
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 3 countries.

Lynn T MatthewsMassachusetts General Hospital, Division of Infectious Disease, Center for Global Health, Boston, Massachusetts, USA. ltmatthews@partners.org
Sengeziwe Sibeko
Leila E Mansoor
Nonhlanhla Yende-Zuma
David R Bangsberg
Quarraisha Abdool Karim
Centre for the AIDS Programme of Research in South Africa · ZAHarvard University · USMbarara University of Science and Technology · UG

Funding

The impact of HIV viral diversity and cellular immunity on HIV pathogenesisP30AI060354 · NIAID · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI ROBERT A. PARKER · 2004 to 2026
$94.4M
Periconception HIV risk reduction for HIV-discordant couples in UgandaK23MH095655 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI MATTHEWS, LYNN T · 2011 to 2015
$854k
Mentoring Patient Oriented Adherence Research in UgandaK24MH087227 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI BANGSBERG, DAVID ROY · 2009 to 2013
$776k
NIAID NIH HHS P30 AI060354NIMH NIH HHS K23 MH095655NIMH NIH HHS K24 MH087227
6 · The paper itself

Abstract

backgroundAntiretroviral prophylaxis may be a critical strategy to reduce periconception HIV transmission. Maximizing the benefit of periconception pharmacologic HIV risk-reduction requires an understanding of the links between pregnancy and adherence to this prevention strategy.

methodsWe assessed study gel adherence among women with pregnancies compared to women without pregnancies enrolled in the CAPRISA 004 phase IIB trial of 1% vaginal tenofovir gel. Pregnancy was assessed with monthly urine tests. Adherence was measured monthly and defined as proportion of sex acts covered by two returned, used applicators based on pre- and post-coital dosing. High adherence was defined as a median adherence score of >80%, that is, more than 80% of sex acts were covered by two applications of study gel. A multivariate generalized estimating equations (GEE) model with a binomial distribution was used to assess covariates associated with high adherence (>80%) over time. Median adherence before and after pregnancy was compared using Wilcoxon signed rank test.

resultsAmong 868 women, 53 had at least 1 pregnancy (4.06 per 100 woman years, 95% CI: 3.04, 5.31). Women with pregnancies had lower median adherence compared to women without pregnancies (50% [IQR: 45-83] vs. 60% [IQR: 50-100], p = 0.02). Women with pregnancies also had a 48% lower odds of high adherence compared to women without pregnancies when adjusting for confounders (aOR 0.52, 95%CI: 0.41-0.66, p<0.0001). Among women with pregnancies, adherence before and after pregnancy was not different (50% [IQR: 46-83] vs. 55% [IQR: 20-100], p = 0.68).

conclusionsWomen with pregnancies were less likely to have high adherence to study gel compared to women without pregnancies. Understanding these differences may inform findings from HIV prevention trials and future implementation of antiretroviral prophylaxis for at-risk women who choose to conceive. The protocol for the parent trial is registered on ClinicalTrials.gov, NCT00441298, http://www.clinicaltrials.gov/ct2/show/NCT00441298.

Indexed as

Medication AdherenceAdenineAdultAnti-HIV AgentsAttitude to HealthDouble-Blind MethodFemaleHIV InfectionsHumansMultivariate AnalysisOdds RatioOrganophosphonatesPregnancySouth AfricaTenofovirVaginal Creams, Foams, and JelliesAdenineAnti-HIV AgentsOrganophosphonatesTenofovirVaginal Creams, Foams, and Jellies

Identifiers

PMID23472071
PMCPMC3589407
OpenAlexW2111938650

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.