Disappointing Results from a Trial of Diaphragm Use for HIV Prevention

Safe and effective female-controlled HIV prevention strategies are desperately needed throughout the world. However, microbicide trials have been unsuccessful (ACC Feb 12 2007), and female condoms remain unpopular. To determine whether diaphragms might have a role in HIV prevention, investigators conducted an open-label trial among 5045 HIV-negative, sexually active women (age range, 18–49) in South Africa and Zimbabwe.

Women were randomized to receive male condoms, either alone (the control group) or with a clinician-fitted diaphragm and lubricant gel (the intervention group). Both groups received pre- and post-test counseling, treatment for curable sexually transmitted infections, and intensive risk-reduction counseling, both at baseline a…