Another blow for HIV prevention

The audio is in isiZulu. See the English summary below.

MABUTHO: Emva kokwehluleka kwekhambi IHVTN503 ngasekupheleni konyaka owedlule, ukubonisa izimpawu zokuvikela igciwane le HIV amathemba abe eseba kwi Carraguard microbicide. ICarraguard, iwuketshezi olugcotshwa esithweni sangasese kumuntu wesifazane ebelihlolelwa ukuvikela igciwane lengculaza. Ibeyikhambi lokuqala lohlobo olwaziwa nge microbicide ukufinyelela esigabeni esibizwa ngo Phase 111 okuyisigaba sokugcina ngaphambi kokuba ikhambi lidluliselwe ezimakethe.  Ethula umbiko, obulindelwe ngabomvu, ngalelikhambi kwingxoxo ebibanjwe nabacosheli bezindaba ngezingcingo UDr Khatidja Ahmed, okunguyena obehola ithimba ebelihlola lelikhambi uthe nakuba lelikhambi libonise ukungabi nabo ubungozi ekusetshenzisweni kwalo kodwa lehlulekile ukubonisa ukuthi lingakwazi ukuvikela lowo olisebenzisayo ukuba angalitholi igciwane lengculaza.

DR KHATIDJA AHMED: The study showed that Carraguard was safe for vaginal use for up to two years. However, the study was unable to demonstrate Carraguard efficacy on male to female transmission of HIV.

MABUTHO: Kubantu besifazane abangu 6,202 ebebekulolucwaningo bangu 4,244 abakwazile ukuthi bafinyelele emaphethelweni alolucwaningo. Kulabo abafinyelele emaphethelweni alolucwaningo abanye babo banikezwe ikhambi okuyilona elihlolwayo, iCarraguard, kwathi abanye banikezwa okungelona elangempela nelibizwa nge Placebo. UDr Ahmed uthi babe ngu 154 abebesebenzisa iPlacebo abothole igciwane kwathi  ebebesebenzisa iCarraguard baba ngu 131. Uthi kodwa lezibalo azisho lutho ngoba umehluko muncane kakhulu. Okunye okuye kwahluluka kumbiko ngemiphumela ye Carraguard ukuthi kubekhona abanye obekuhlolwa kubona lelikhambi ebebengalisebenzisi njalo. Ngokusho kuka Dr Ahmed ukungasetshenziswa njalo kwalo kungenzeka ukuthi kube nawo umthelela kwimiphumela ngoba abacwaningi abakwazi ukuthi balandelele ukuthi ikhambi lisetshenziswa zikhathi zonke. Kepha uthi ukungasetshenziswa njalo kwalo ngabanye kakusho lutho ngoba imiphumela yalolucwaningo igxile kulabo abebelisebenzisa izikhathi eziningi.

DR KHATIDJA AHMED: Controlling the use of the product outside the research centre is very limited to the researchers. We know that the product has not been used as effectively or as consistently as we would like to. And yes it may have an outcome on the results on the results or the outcome of Carraguard. But… more analysis has been conducted in groups of women that have utilized the product more.

MABUTHO: UDr Ahmed uthi nakuba bephatheke kabi bona njengabacwaningi ngemiphumela engemihle ye Carraguard uthi kodwa lokho akubadikibalisi ngoba luningi ulwazi olutholakele ngokuhlolwa kwalelikhambi nathi luyosiza ekuqhubezeleni ucwaningo ngesikhathi esizayo.

DR KHATIDJA AHMED: A lot of people might view it as a setback for prevention options, especially in the South African context. However, we as researchers do not feel it is a setback, but rather that we’€˜ve gained so much information from this trial and it’€™s a step forward.

MABUTHO: Kanti nangaphambi kokuba amemezele ukukhishwa kwalemiphumela kwingxoxo ekhethekile ne Health-e, uDr Ahmed, wakubeka kwacaca ukuthi noma ngabe ithini imiphumela kodwa ukucwaningwa kwe Carraguard kube usizo kakhulu hhayi nje kubona njengabacwaningi kuphela kepha nakwabesifazane ebebeyingxenye yokucwaningwa kwayo.

Dr KHATIDJA AHMED: The most important thing is that we have educated such a large number of women in the community’€¦ We’€™ve educated them on research; we’€™ve educated them on sexual behaviour; we’€™ve educated them on HIV; we’€™ve educated them on other sexually transmitted infections. We’€™ve empowered the women in that context.

MABUTHO: Ukuba imiphumela ye Carraguard impumelelo bekuyosho lukhulu kwabesifazane. Lokhu kungenxa yokuthi izikhathi eziningi abesifazane banenkinga yokuncenga abesilisa ukuba basebenzise amakhondomu ukuvikela ukuthola iHIV.

See the English summary below.

Another blow for HIV prevention

Attempts on the HIV prevention front have been dealt yet another blow, following the failure of the Carraguard microbicide to prove effective in preventing HIV infection from males to females.

The news of Carraguard’€™s failure comes barely five months after the trials of the biggest HIV vaccine ever to be conducted on the continent, HVTN503 vaccine dubbed ‘€œPhambili’€, was stopped with immediate effect after its sister trials in the US and Australia found no protection against HIV infection.

According to the Carraguard principal investigator, Dr Khatidja Ahmed, ‘€œthe study showed that Carraguard was safe for vaginal use for up to two years. However, the study was unable to demonstrate Carraguard efficacy on male to female transmission of HIV’€.

At least 6 202 participants took part when the study was started two years ago. They were randomly given either Carraguard or a placebo gel. There  are 4,244 participants who completed the study.    

At the end of the study, there were 134 new HIV infections in the Carraguard group and 151 in the placebo group. A result, which is regarded as statistically insignificant.

The analysis of the study shows that some of the participants did not use the gel as often as they should, but Dr Ahmed says that has little impact on the study.

‘€œControlling the use of the product outside the research centre is very limited to the researchers. We know that the product has not been used as effectively or as consistently as we would like to. And yes it may have an outcome on the results of Carraguard. But… more analysis has been conducted in groups of women that have utilized the product more,’€ she said.

Despite the disappointing results of the study Dr Ahmed says there is lot that has been learned from the study that can be used in the future.    

‘€œA lot of people might view it as a setback for prevention options, especially in the South African context. However, we as researchers do not feel it is a setback, but rather that we’€˜ve gained so much information from this trial and it’€™s a step forward’€.

Two months before the announcement of the results Dr Ahmed told Health-e that regardless of the study result outcome it has empowered thousands of women through research education, sexual behaviour, HIV and on sexually transmitted infections.

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