Artigo Revisado por pares

Contraceptive Efficacy of a Novel Spermicidal Microbicide Used With a Diaphragm

2007; Lippincott Williams & Wilkins; Volume: 110; Issue: 3 Linguagem: Inglês

10.1097/01.aog.0000278078.45640.13

ISSN

1873-233X

Autores

Kurt T. Barnhart, M. J. Rosenberg, H. Trent MacKay, Diana Blithe, Jim Higgins, Terri Walsh, Livia Wan, Michael A. Thomas, Mitchell D. Creinin, Carolyn Westhoff, William D. Schlaff, David F. Archer, Charletta Ayers, Andrew M. Kaunitz, Sutapa Das, Thomas R. Moench,

Tópico(s)

Adolescent Sexual and Reproductive Health

Resumo

In Brief OBJECTIVE: Women need products that protect against both pregnancy and sexually transmitted infections, including human immunodeficiency virus (HIV). The acid buffering gel is a nondetergent spermicide that may provide this dual protection by reinforcing normal vaginal acidity to inactivate both sperm and acid-sensitive sexually transmitted pathogens. The objective of this study was to assess the gel's contraceptive effects, safety, and acceptability. METHODS: We conducted a multicenter, randomized, double-masked, noninferiority study at 11 centers, comparing 621women who used an acid buffering gel plus diaphragm with 300 women who used a nonoxynol-9 spermicide plus diaphragm for 6 months. A double-masked study extension followed 234 women for an additional 6 months of use. RESULTS: The 6-month pregnancy rate per hundred women was 10.1% (95% confidence interval [CI] 7.1–13.1%) for acid buffering gel and 12.3 (95% CI 7.7–16.9) for nonoxynol-9 spermicide users. The difference in rates was –2.2% with a 95% CI –7.7 to 3.3%. Consistent and correct use 6-month pregnancy rates were 4.7% for acid buffering gel and 6.1% for nonoxynol-9 spermicide users, calculated from those cycles where diary entries indicated such use. Adverse events and acceptability were similar between the two groups. Pregnancy probabilities were similar between groups participating in the 12-month study extension. CONCLUSION: An acid buffering gel used with a diaphragm is a safe, acceptable contraceptive with efficacy comparable to that of a common commercial spermicide with diaphragm. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.ClinicalTrials.gov, NCT00065858 LEVEL OF EVIDENCE: I A novel acid buffering gel is safe and acceptable and has contraceptive efficacy comparable to that of a common commercial spermicide with diaphragm.

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