Recruitment of high risk women for HIV prevention trials: baseline HIV prevalence and sexual behavior in the CAPRISA 004 tenofovir gel trial

Quarraisha Abdool Karim, Ayesha Bm Kharsany, Janet A Frohlich, Cheryl Baxter, Nonhlanhla Yende, Leila E Mansoor, Koleka P Mlisana, Silvia Maarschalk, Natasha Arulappan, Anneke Grobler, Sengeziwe Sibeko, Zaheen Omar, Tanuja N Gengiah, Mukelisiwe Mlotshwa, Natasha Samsunder, Salim S Abdool Karim, Quarraisha Abdool Karim, Ayesha Bm Kharsany, Janet A Frohlich, Cheryl Baxter, Nonhlanhla Yende, Leila E Mansoor, Koleka P Mlisana, Silvia Maarschalk, Natasha Arulappan, Anneke Grobler, Sengeziwe Sibeko, Zaheen Omar, Tanuja N Gengiah, Mukelisiwe Mlotshwa, Natasha Samsunder, Salim S Abdool Karim

Abstract

Background: Young women in sub-Saharan Africa bear a disproportionate burden of HIV infection compared to men but have limited options to reduce their HIV risk. Microbicides could fill an important HIV prevention gap for sexually active women who are unable to successfully negotiate mutual monogamy or condom use.

Purpose: This paper describes the baseline sample characteristics in the CAPRISA 004 trial which assessed the safety and effectiveness of the vaginal microbicide, 1% tenofovir gel for HIV prevention in South Africa.

Methods: This analysis assessed the baseline demographic, clinical and sexual behavior data of women screened and enrolled into the trial. The characteristics were summarized using descriptive summary measures; expressed as means and percent for categorical variables.

Results: HIV prevalence at screening was 25.8% [95% Confidence Interval (CI):23.9-27.7). Of the 889 eligibly enrolled women who contributed follow-up data, rural participants recruited from a family planning (FP) clinic were younger, more likely to be living apart from their regular partner, reported lower coital frequency, had lower condom use (p < 0.001). In contrast, urban participants recruited from a sexually transmitted disease (STD) clinic reported higher numbers of lifetime sexual partners, new partners in the last 30 days and receiving money in exchange for sex (p < 0.001).

Conclusion: The populations selected provide suitable diverse target groups for HIV prevention intervention studies.

Trial registration: ClinicalTrials.gov: NCT 00441298.

Trial registration: ClinicalTrials.gov NCT00441298.

Figures

Figure 1
Figure 1
Screening, enrolment and randomization of CAPRISA 004 trial participants.

References

    1. Abdool Karim SS, Churchyard GJ, Abdool Karim Q, Lawn SD. HIV infection and tuberculosis in South Africa: an urgent need to escalate the public health response. Lancet. 2009;374:921–933. doi: 10.1016/S0140-6736(09)60916-8.
    1. UNAIDS World Health Organization. AIDS epidemic update: November 2009. 2009. "UNAIDS/09.36E/JC1700E". ISBN 978 92 9173 832 8 (NLM classification: WC 503.41)
    1. Pettifor AE, Rees HV, Kleinschmidt I, Steffenson AE, MacPhail C, Hlongwa-Madikizela L. et al.Young people's sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household survey. AIDS. 2005;19:1525–1534. doi: 10.1097/01.aids.0000183129.16830.06.
    1. Shisana O, Rehle T, Simbayi LC, Zuma K, Jooste S, Pillay-van-Wyk V, South African national HIV prevalence, incidence, behaviour and communication survey 2008: A turning tide among teenagers? Cape Town: HSRC Press; 2009.
    1. Barnighausen T, Tanser F, Gqwede Z, Mbizana C, Herbst K, Newell ML. High HIV incidence in a community with high HIV prevalence in rural South Africa: findings from a prospective population-based study. AIDS. 2008;22:139–144. doi: 10.1097/QAD.0b013e3282f2ef43.
    1. Pettifor A, Macphail C, Rees H, Cohen M. HIV and sexual behavior among young people: the South African paradox. Sex Transm Dis. 2008;35:843–844. doi: 10.1097/OLQ.0b013e31818318c0.
    1. Cowan F, Pettifor A. HIV in adolescents in sub-Saharan Africa. Curr Opin HIV AIDS. 2009;4:288–293. doi: 10.1097/COH.0b013e32832c7d10.
    1. Quinn TC, Overbaugh J. HIV/AIDS in women: an expanding epidemic. Science. 2005;308:1582–1583. doi: 10.1126/science.1112489.
    1. Frohlich JA, Kharsany ABM, Carrara H, Makhaye GM, Abdool Karim SS, Abdool Karim Q. Temporal Trends in HIV infection in Rural South Africa: Implications for HIV Prevention Research. XV INTERNATIONAL AIDS CONFERENCE BANGKOK 11-16 JULY 2004 Abstract number MoPpC2013. 2004.
    1. Ramjee G, Kapiga S, Weiss S, Peterson L, Leburg C, Kelly C. et al.The value of site preparedness studies for future implementation of phase 2/IIb/III HIV prevention trials: experience from the HPTN 055 study. J Acquir Immune Defic Syndr. 2008;47:93–100. doi: 10.1097/QAI.0b013e31815c71f7.
    1. Abdool Karim Q, Kharsany A, Frohlich J, Werner L, Mashego M, Mlotshwa M, Stabilizing HIV prevalence masks high HIV incidence rates amongst rural and urban women in KwaZulu-Natal, South Africa. International Journal of Epidemiology. 2010.
    1. Collins C, Coates TJ, Curran J. Moving beyond the alphabet soup of HIV prevention. AIDS. 2008;22(Suppl 2):S5–8. doi: 10.1097/01.aids.0000327431.82795.49.
    1. Padian NS, Buve A, Balkus J, Serwadda D, Cates W Jr. Biomedical interventions to prevent HIV infection: evidence, challenges, and way forward. Lancet. 2008;372:585–599. doi: 10.1016/S0140-6736(08)60885-5.
    1. Coates TJ, Richter L, Caceres C. Behavioural strategies to reduce HIV transmission: how to make them work better. Lancet. 2008;372:669–684. doi: 10.1016/S0140-6736(08)60886-7.
    1. Feldblum PJ, Adeiga A, Bakare R, Wevill S, Lendvay A, Obadaki F. et al.SAVVY vaginal gel (C31G) for prevention of HIV infection: a randomized controlled trial in Nigeria. PLoS One. 2008;3:e1474. doi: 10.1371/journal.pone.0001474.
    1. Peterson L, Nanda K, Opoku BK, Ampofo WK, Owusu-Amoako M, Boakye AY. et al.SAVVY (C31G) gel for prevention of HIV infection in women: a Phase 3, double-blind, randomized, placebo-controlled trial in Ghana. PLoS One. 2007;2:e1312. doi: 10.1371/journal.pone.0001312.
    1. Skoler-Karpoff S, Ramjee G, Ahmed K, Altini L, Plagianos MG, Friedland B. et al.Efficacy of Carraguard for prevention of HIV infection in women in South Africa: a randomised, double-blind, placebo-controlled trial. Lancet. 2008;372:1977–1987. doi: 10.1016/S0140-6736(08)61842-5.
    1. Van Damme L, Govinden R, Mirembe FM, Guedou F, Solomon S, Becker ML. et al.Lack of effectiveness of cellulose sulfate gel for the prevention of vaginal HIV transmission. N Engl J Med. 2008;359:463–472. doi: 10.1056/NEJMoa0707957.
    1. Van Damme L, Ramjee G, Alary M, Vuylsteke B, Chandeying V, Rees H. et al.Effectiveness of COL-1492, a nonoxynol-9 vaginal gel, on HIV-1 transmission in female sex workers: a randomised controlled trial. Lancet. 2002;360:971–977. doi: 10.1016/S0140-6736(02)11079-8.
    1. Abdool Karim S, Coletti A, Richardson B, Ramjee G, Hoffman I, Chirenje M, Safety and effectiveness of vaginal microbicides buffer gel and 0.5% PRO 2000/5 gel for the prevention of HIV Infection in women: results of the HPTN 035 trial. Montreal, Canada; 2009. Oral Abstract 48LB, 16th Conference on Retroviruses and Opportunistic Infections.
    1. IOM (Institute of Medicine) Methodological challenges in biomedical HIV prevention trials. Washington, DC: The National Academies Press; 2008.
    1. Abdool Karim Q, Abdool Karim SS, Frohlich JA, Grobler AC, Baxter C, Mansoor LE. et al.Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010;329:1168–1174. doi: 10.1126/science.1193748.
    1. MacQueen KM, Karim QA. Practice brief: adolescents and HIV clinical trials: ethics, culture, and context. J Assoc Nurses AIDS Care. 2007;18:78–82. doi: 10.1016/j.jana.2007.01.002.
    1. Cockcroft D, Gault M. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16:31–41. doi: 10.1159/000180580.
    1. Kharsany AB, Hancock N, Frohlich JA, Humphries HR, Abdool Karim SS, Abdool Karim Q. Screening for 'window-period' acute HIV infection among pregnant women in rural South Africa. HIV Med. 2010;11:661–665. doi: 10.1111/j.1468-1293.2010.00838.x.
    1. Abdool Karim Q, Kharsany ABM, Naidoo K, Yende N, Gengiah T, Omar Z, Co-enrollment in multiple HIV prevention trials: Experiences from the CAPRISA 004 Tenofovir gel trial. Contemp Clin Trials. 2011. in press .
    1. International Conference on Harmonisation guidelines E9. International Conference on Harmonisation of technical requirements for registration of pharmaceuticals for human use. ICH harmonised tripartate guideline statistical principles for clinical trials-E9. 1998.
    1. Welz T, Hosegood V, Jaffar S, Batzing-Feigenbaum J, Herbst K, Newell ML. Continued very high prevalence of HIV infection in rural KwaZulu-Natal, South Africa: a population-based longitudinal study. AIDS. 2007;21:1467–1472. doi: 10.1097/QAD.0b013e3280ef6af2.
    1. van Loggerenberg F, Mlisana K, Williamson C, Auld SC, Morris L, Gray CM. et al.Establishing a cohort at high risk of HIV infection in South Africa: challenges and experiences of the CAPRISA 002 acute infection study. PLoS One. 2008;3:e1954. doi: 10.1371/journal.pone.0001954.

Source: PubMed

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