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The search for an effective anti-HIV vaginal microbicide has yielded as many disappointments as has the search for an effective vaccine. Eighteen months ago, a large trial of intravaginal cellulose sulfate gel was stopped prematurely because of data suggesting that the product enhanced HIV acquisition (AIDS Clin Care Sep 10 2007). The full details of the study have now been published.
Almost 1400 sexually active HIV-negative women in Africa and India (median age, 29) were randomized to use either cellulose sulfate or placebo gel in the hour preceding vaginal intercourse. The median number of male partners in the 3 months before screening was 10, with a median of four episodes of vaginal intercourse reported for the week before screening.
The …