The Diaphragm and Lubricant Gel for Prevention of Cervical Sexually Transmitted Infections: Results of a Randomized Controlled Trial
2008

Diaphragm and Lubricant Gel for Preventing Cervical STIs

Sample size: 5045 publication 10 minutes Evidence: moderate

Author Information

Author(s): Ramjee Gita, van der Straten Ariane, Chipato Tsungai, de Bruyn Guy, Blanchard Kelly, Shiboski Stephen, Cheng Helen, Montgomery Elizabeth, Padian Nancy

Primary Institution: Medical Research Council, Durban, South Africa

Hypothesis

Does the use of a diaphragm and lubricant gel reduce the incidence of chlamydial and gonococcal infections compared to condoms alone?

Conclusion

The study found no significant difference in the rate of chlamydial or gonococcal infections between the diaphragm and lubricant gel group and the control group, but consistent use of the diaphragm may reduce gonococcal infections.

Supporting Evidence

  • The study included 5045 women and followed them for an average of 21 months.
  • There were 471 first chlamydia infections and 192 first gonococcal infections recorded during the study.
  • The retention rate of participants was over 93% throughout the study.

Takeaway

The study tested if a diaphragm and lubricant gel could help prevent certain infections in women, but it didn't show a clear benefit over just using condoms.

Methodology

The study was a randomized controlled trial involving 5045 sexually active women, comparing the incidence of STIs between those using a diaphragm with lubricant gel and those using condoms only.

Potential Biases

There may be bias in self-reported adherence to diaphragm use.

Limitations

The study did not account for potential confounding factors such as varying rates of condom use across study arms.

Participant Demographics

Participants were sexually active women aged 18-49, primarily under 35 years old, recruited from Southern Africa.

Statistical Information

P-Value

p=0.25 for CT; p=0.90 for GC; p=0.02 for per-protocol analysis of GC

Confidence Interval

95% CI: 0.93–1.33 for CT; 95% CI: 0.74–1.30 for GC; 95% CI: 0.41–0.91 for per-protocol analysis of GC

Statistical Significance

p=0.25 for CT; p=0.90 for GC; p=0.02 for per-protocol analysis of GC

Digital Object Identifier (DOI)

10.1371/journal.pone.0003488

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