Sad news: a study that was hoping to show that diaphragms are a useful, woman-controlled method of preventing HIV infection showed instead that they have no effect.
Researchers are desperately seeking a low-cost method that women could use — without the consent of male partners — to protect themselves against HIV. About 20 percent of adults are infected in Zimbabwe and South Africa, where the experiment was conducted, and women there run twice the risk of infection as men. In cultures where women are traditionally subservient to men, they have less of a say about matters of sex — when to have it, whom to have it with, and whether condoms or other safer sexual practices will be used.
The study was conducted in Durban and Johannesburg, South Africa, and in Harare, Zimbabwe. It enrolled nearly 5,000 women ages 18-49 and followed them an average of 18 months. Half of the women were given diaphragms and a gel lubricant, while the other half were not. Both groups were also given condoms and extensive counseling to have their partners use them.
By the end of the study, HIV infection rates were high and almost identical: about 4 percent of the women in each arm of the study were infected per year. Infections were found in 158 women given diaphragms and condoms and counseling; 151 women were infected among those given condoms and counseling only.
I’ve written before about the need for women-controlled methods of prevention. It’s a dire need for women who do not have the choice over whether or not to engage in sexual activity and the inability to force their partners to remain faithful and/or use condoms, particularly in countries with the highest infection rates. Obviously we should be focusing on improving the overall lives and status of these women, but these things don’t happen overnight. In the many years that it will take to change minds, lives still need to be saved. So this is very disheartening news. Female condoms are an option, the problem being that, unlike the diaphragm, one’s partner can clearly tell when it is being used (and if your partner has the power over you to refuse to wear a condom, chances are that he will veto you using one, too).
According to the article, there are more studies about female-controlled HIV-prevention methods in the works, mostly using gels. But we won’t see results from these for several years. There was a lot of hope around this study, and there’s just no way around it: this sucks.
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This is sad news, but the bright side of it is to hear that “researchers are desperately seeking a low-cost method that women could use — without the consent of male partners — to protect themselves against HIV.” This is so important, and I’m glad there is work being done on this.
Um, since the vaginal walls were still being exposed to the virus wouldn’t infection continue to be easy (especially with rough sex and therefore vaginal injury)? I realize why they hoped diaphragms would be an answer as opposed to female condoms, but at the same time don’t see how diaphragms could have solved the problem. Is it much much easier for women to contract HIV through the cervix and beyong than through the vagina?
My best guess is that they really had no way of knowing (how exactly would you trial that?), but had a hunch that it was easier to contract through the cervix, unless there were abrasions on the vaginal wall. But again, that’s just a hunch.
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