P14.09
Background: Sub-Saharan Africa continues to bear a towering share of the global HIV burden with 70% new HIV infections. HIV prevalence among young women remains more than twice as high as among young men throughout sub-Saharan Africa Therefore, it is important to perform a needs assessment for women enrolled in HIV prevention trials as a strategy to increase adherence to investigational products. The aim of this study is to assess commitment to prevention interventions by measuring pregnancy and HIV incidence in relation to product adherence.
Methods: This study included data collected from women (n=1456) enrolled in the Carraguard vaginal microbicide gel trial. Associations between gel adherence and pregnancy and HIV incidence in women during the study follow-up were described using Kaplan-Meier and Cox regression analysis. Statistical analysis was performed using STATA release 12.0 (College Station, Texas, TX, USA).
Results: The highest crude incidence rates for pregnancy (6.7 per 100 person year (py), 95% Confidence interval (CI) 5.1, 8.9) and HIV (8.5 per 100/py, 95% CI: 6.2, 11.6) were reported for women that were in the 2nd quartile of % gel used with condoms (35- <55%). After adjusting for age, number of sexual partners in the last 3 months, number of sex acts in the last week and marital status; women that had very low gel adherence with condom use were at increased risk for incident pregnancy (1st quartile<35%), Hazard Ratio (HR) 2.4, 95% CI: and HIV infections (2nd quartile 35- <55%, HR: 3.5, 95% CI: 1.8, 7.0) when compared to high adherers (>75% gel adherence with condom use, HR: 1 per 100 p/y respectively).
Conclusions: These findings suggest that adherence to study product and condom promotion is critical to prevent infection with HIV as well as reduce pregnancy incidence.
