HIV Infections Clinical Trial
Official title:
A Phase 1 Safety and Acceptability Study of Carraguard® Among HIV Positive Women and Men in Durban, South Africa
The study objectives were to assess the mucosal safety of Carraguard® gel when applied vaginally once per day for 14 days by sexually abstinent and sexually active, HIV-positive women; to evaluate the effect of Carraguard® gel on the vaginal flora in these women; to evaluate the effect of Carraguard® gel on shedding of HIV-1 in the genital tract of these women; to evaluate the safety of Carraguard® gel when applied directly to the penis once per day for 7 days by sexually abstinent, HIV-positive men; to assess whether symptoms reported by female and male participants during the study may be related to the use of Carraguard® gel; and to examine dimensions of the acceptability of, and compliance with, the study and placebo products.
We proposed a safety study of the Council's lead candidate microbicide, Carraguard® in three
cohorts in Durban, South Africa: sexually abstinent HIV-positive women, sexually abstinent
HIV-positive men, and sexually active HIV-positive women. Sexually active women must be in an
HIV-positive seroconcordant relationship (confirmed by HIV testing of the woman and her male
partner) and written informed consent was obtained from the male partners. Women and men in
each cohort were randomized to one of three study groups: Carraguard® gel, its matching
placebo methyl-cellulose gel, or no product.
The main objectives of this study were to investigate changes in the vulvar, vaginal, and
cervical epithelia, the vaginal flora, and HIV-1 shedding in the genital tract of female
participants, and changes of the penile skin and epithelia of male participants. We also
evaluated symptoms reported by participants, and several dimensions of the acceptability of
and compliance with the study or placebo gel. Reactions to a non-contraceptive microbicide
were assessed, as well as reasons for voluntary discontinuation and non-use of Carraguard® or
the placebo (determined by review of daily diary) was recorded. Exit focus group discussions
were held with male and female participants to discuss aspects of acceptability and
compliance. Self-reported symptoms were also investigated by clinical examination as needed
and study endpoints included genital itching or burning, frequent urination, burning while
urinating, genital pain, pain during sex, and abnormal vaginal or penile discharge.
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