Zimbabwean women very willing to use diaphragms-potential HIV prevention method

Almost all (98 percent) Zimbabwean women who were unable to persuade their male partners to use condoms consistently, used the diaphragm as an alternative method of contraception and disease prevention, though its effectiveness against HIV remains unknown, UCSF researchers have found.

"There is substantial evidence to suggest that protecting the cervix could offer some protection against HIV, but attempts to study physical barriers that protect the cervix such as diaphragms have been stymied by the issue of acceptability. Western researchers simply have not believed that women will use them. Now that we know that they are acceptable, diaphragms need to be tested for efficacy in preventing HIV," said co-author Tsungai Chipato, MD, University of Zimbabwe professor of obstetrics and gynecology at the UZ -UCSF Collaborative Research Programme in Women's Health.

Chipato is presenting the findings at the XIV International AIDS Conference in Barcelona, Spain.

"The cervix appears to be a "hot spot" in terms of susceptibility to HIV. It is very thin and fragile and has more cells with HIV specific receptor sites than the vagina. Also, the peristalic contractions of the uterus actually draw fluids up into the upper genital track-an area that is very susceptible to HIV and other sexually transmitted diseases (STDs). This rapid upward movement of fluid is thought to enhance fertility but also transports HIV and STD causing pathogens," said the study's principal investigator, Nancy Padian, PhD, UCSF professor of obstetrics, gynecology and reproductive services and director of international programs at UCSF's AIDS Research Institute.

Data from observational studies show that protecting the cervix protects against bacterial STDs, and these STDs are proven to facilitate transmission of HIV. Also, diaphragms, which can also be vehicles to hold spermicides, may thus increase the effectiveness of new microbicides that are designed to prevent HIV ac

Contact: Jeff Sheehy
University of California - San Francisco

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