Evidence map›Paper›PMID 31381878›Full record

Trial reportContraception2019

Comparison of self-reported female condom failure and biomarker-confirmed semen exposure.

Terri L Walsh, Margaret C Snead, Breione J St Claire, Jill L Schwartz, Christine K Mauck, Ron G Frezieres, Diana L Blithe, David F Archer, Kurt T Barnhart, Jeffrey T Jensen and 4 more

Abstract readClinical Trial, Phase IIIComparative StudyMulticenter Study
In one paragraph

Trial report in Contraception, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. 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

14 authors.

Terri L WalshEssential Access Health (formerly California Family Health Council), 3600 Wilshire Blvd., Ste. 600, Los Angeles, CA 90010. Electronic address: twalsh@essentialaccess.org.
Margaret C SneadDivision of Reproductive Health, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333.
Breione J St ClaireEssential Access Health (formerly California Family Health Council), 3600 Wilshire Blvd., Ste. 600, Los Angeles, CA 90010.
Jill L SchwartzCONRAD/EVMS, 1911 N. Fort Myer Drive, Ste. 900, Arlington, VA 22209.
Christine K MauckCONRAD/EVMS, 1911 N. Fort Myer Drive, Ste. 900, Arlington, VA 22209.
Ron G FrezieresEssential Access Health (formerly California Family Health Council), 3600 Wilshire Blvd., Ste. 600, Los Angeles, CA 90010.
Diana L BlitheContraceptive Development Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, 6710B Rockledge Dr, Bethesda, MD 20817.
David F ArcherObstetrics & Gynecology, Eastern Virginia Medical School, PO Box 1980, Norfolk, VA 23501.
Kurt T BarnhartUniversity of Pennsylvania Medical Center, 3701 Market St., Ste. 800, Philadelphia, PA 19104.
Jeffrey T JensenDepartment of Obstetrics & Gynecology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239.
Anita L NelsonEssential Access Health (formerly California Family Health Council), 3600 Wilshire Blvd., Ste. 600, Los Angeles, CA 90010.
Michael A ThomasDepartment of Obstetrics & Gynecology, University of Cincinnati Medical Center, 234 Goodman St., Cincinnati, OH 45219.
Livia S WanDepartment of Obstetrics & Gynecology, New York University,462 First Ave., New York, NY 10016.
Mark A WeaverDepartment of Mathematics and Statistics, Elon University, Elon, NC 27244.

Funding

Development of novel contraceptive methods for men and womenZIBHD008987 · NICHD · EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT · PI BLITHE, DIANA · 2019 to 2025
$7.2M
Intramural CDC HHS CC999999PEPFAR
6 · The paper itself

Abstract

objectiveTo investigate whether rates of self-reported Woman's Condom (WC) clinical failure and semen exposure from a functionality study are comparable to results from a contraceptive efficacy substudy. STUDY

designWe structured our comparative analysis to assess whether functionality studies might credibly supplant contraceptive efficacy studies when evaluating new female condom products. Couples not at risk of pregnancy in the functionality (breakage/slippage/invagination/penile misdirection) study and women in the contraceptive efficacy study completed condom self-reports and collected precoital and postcoital vaginal samples for up to four uses of the WC. Both studies used nearly identical self-report questions and the same self-sampling procedures and laboratory for prostatic specific antigen (PSA), a well-studied semen biomarker. We compared condom failure and semen exposure proportions using generalized estimating equations methods accounting for within-couple correlation.

resultsNinety-five (95) efficacy substudy participants used 334 WC and 408 functionality participants used 1572 WC. Based on self-report, 19.2% WC (64 condoms) clinically failed in the efficacy substudy compared to 12.3% WC (194 condoms) in the functionality study (p=.03). Of the 207 WC efficacy uses with evaluable postcoital PSA levels, 14.5% (30 uses) resulted in semen exposure compared to 14.2% (184 uses) of the 1293 evaluable WC functionality study uses.

conclusionsWhen evaluating the ability of an experimental condom to prevent semen exposure, the rate of clinical condom failure reported by participants risking pregnancy in an efficacy substudy was significantly higher than the rate reported by participants not risking pregnancy in a functionality study. The rate of semen exposure, assessed by an objective biomarker was nearly identical for the two studies. IMPLICATIONS: Our results suggest that an objective marker of semen exposure in functionality studies could provide a reasonable alternative to contraceptive efficacy studies in evaluating risk of unintended pregnancy and inferring protection from sexually transmitted infection than condom failure rates based on self-report.

Indexed as

AdultContraceptive EffectivenessFemaleHumansMaleProstate-Specific AntigenSelf ReportSemenSingle-Use Internal CondomProstate-Specific AntigenCondom clinical failureContraceptive efficacyFemale internal condomProstate-specific antigen (PSA)Semen biomarkersSexually transmitted infection

Identifiers

PMID31381878
PMCPMC6875637

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.