The announcement of the much-awaited Caprisa results in July has elicited a mixed reaction among communities, with some suggesting that it might worsen the rate of condom use. Vusi Msiza, from Kwa-Tema, on Gauteng’€™s East Rand, said that the results have brought hope, but cautioned that they could also create a misperception.

‘€œIt is good that we had this study, but I am also scared that people will stop using condoms and there might be issues of new infections if we don’€™t do well in terms of messaging the whole thing. We need to advocate, so we are clear. I also want to challenge men to take initiative’€¦ let us men take initiative of saying we need to use condoms and supporting our women’€, Msiza said.

A woman who is part of an HIV/AIDS community support group in Benoni, also on Gauteng’€™s East Rand, agrees that the tenofovir gel may signal an incorrect message. The woman, who wanted to remain anonymous and lives in an informal settlement, expressed her concern in some women not being given a choice by their men to use protection.

‘€œSome are not allowed to even use those condoms. If they do, then they get hit or don’€™t get money to buy food in the house. One woman told me that as it is now, her man was not here for a whole week. He was not sleeping at home, but when he came back he just wanted to have sex and didn’€™t want me to ask questions on where he was from or that we should use condoms. He just wanted it like that and I had to give him. He is the breadwinner in the house; otherwise her and her children won’€™t get food. So, I hope that this gel doesn’€™t discourage people from using condoms’€, she said.

But other members of the community have hailed the results of the Caprisa study, saying it will give women some power as there are perceived stereotypes in using condoms. Charles Hlatshwayo who is part of a community advisory board on clinical trials in Soweto, said that the results spell good news. However, he cautioned that there might be resistance towards the gel.

‘€œWith the entire Soweto people and, maybe South Africans, they might still be sceptic in terms of understanding what it is exactly and what it entails. It will be a struggle to use this gel when it comes as are condoms already. Maybe 5 out of 10 people might use it. It’€™s a struggle for our women in the communities to negotiate safe sex, men seem to be stereotyped about using condoms with their partners’€, Hlatshwayo said.

The Caprisa results showed that HIV infection can be reduced by 39% if used consistently. The study was conducted on more than 800 women in South Africa between the ages of 18 and 40. The investigating team says throughout its study it encouraged participants to continue using condoms. They say the results of the study also indicate that there was no increase in risky behaviour among participants.

Principal Investigator of the Caprisa study, Professor Quarraisha Abdool Karim, explained the results of the study.  

‘€œWe ended up with a total of 98 HIV infections – 38 got infected in the tenofovir arm and 60 got infected in the placebo arm. This is 38 out of 445 and 60 out of 444. There is a lot more infection in the placebo arm.   We also look at how the infection occurs over time. Up to 12 months we had 65. HIV infections occurred at the 12 month of follow-up. These are people we had enrolled in the study and had completed the 12 months of study visit’€.

Professor Abdool Karim has urged women to continue to use condoms as protection during sexual intercourse, saying the results of the Caprisa study should not discourage the use of condoms. She said double protection is required.