Assessment of risk compensation following use of the dapivirine vaginal ring in southwestern Uganda

Sex Transm Infect. 2022 Feb;98(1):32-37. doi: 10.1136/sextrans-2020-054718. Epub 2021 Feb 4.

Abstract

Objectives: Participation in HIV prevention trials could trigger risk compensation among participants. We evaluated potential risk compensation following use of a vaginal ring microbicide by women in a phase III trial in southwestern Uganda.

Methods: We used markers of sexual risk behaviour documented on standardised questionnaires, tested for STIs at baseline and quarterly for 2 years. Risk compensation was defined as a significant increase (trend p<0.05) in the proportion of women reporting risky sexual behaviour or a diagnosed STI between baseline and end of follow-up.

Results: Between September 2013 and December 2016, 197 women (active arm: n=132 and placebo: n=65) were enrolled at the Masaka site. There were decreases in all markers of sexual risk behaviour with statistically significant decreases in only the proportion of women reporting ≥2 sexual partners, p=0.026 and those diagnosed with Trichomonas vaginalis p<0.001 and or Neisseria gonorrhoeae p<0.001 CONCLUSIONS: No evidence of risk compensation was observed in this trial.

Trial registration number: NCT01539226.

Keywords: HIV; sexual behaviour; vaginal microbicides; women.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Anti-HIV Agents / pharmacology*
  • Contraceptive Devices, Female / standards*
  • Female
  • HIV Infections / prevention & control*
  • Humans
  • Pyrimidines / pharmacology*
  • Risk Factors
  • Sexual Behavior
  • Young Adult

Substances

  • Anti-HIV Agents
  • Pyrimidines
  • Dapivirine

Associated data

  • ClinicalTrials.gov/NCT01539226