Effectiveness of the female condom in preventing HIV and sexually transmitted infections: a systematic review and meta-analysis

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dc.contributor.authorWiyeh, Alison B
dc.contributor.authorMome, Ruth K B
dc.contributor.authorMahasha, Phetole W
dc.contributor.authorKongnyuy, Eugene J
dc.contributor.authorWiysonge, Charles S
dc.date.accessioned2020-04-15T08:48:08Z
dc.date.available2020-04-15T08:48:08Z
dc.date.issued2020-03-12
dc.date.updated2020-03-15T05:05:40Z
dc.description.abstractAbstract Background The effectiveness of female condoms for preventing HIV and sexually transmitted infections (STIs) remains inconclusive. We examined the effects of female condoms on the acquisition of HIV and STIs. Methods We searched four databases, two trial registries, and reference lists of relevant publications in October 2018 and updated our search in February 2020. We screened search output, evaluated study eligibility, and extracted data in duplicate; resolving differences through discussion. We calculated the effective sample size of cluster randomised trials using an intra-cluster correlation coefficient of 0·03. Data from similar studies were combined in a meta-analysis. We performed a non-inferiority analysis of new condoms relative to marketed ones using a non-inferiority margin of 3%. We assessed the certainty of evidence using GRADE. Results We included fifteen studies of 6921 women. We found that polyurethane female condoms (FC1) plus male condoms may be as effective as male condoms only in reducing HIV acquisition (1 trial, n = 149 women, RR 0.07, 95%CI 0.00–1.38; low-certainty evidence). However, the use of FC1 plus male condoms is superior to male condoms alone in reducing the acquisition of gonorrhoea (2 trials, n = 790, RR 0.59, 95%CI 0.41–0.86; high-certainty evidence) and chlamydia (2 trials, n = 790, RR 0.67, 95%CI 0.47–0.94; high-certainty evidence). Adverse events and failure rates of FC1 were very low and decreased during follow up. Although the functionality of newer female condoms (Woman’s, Cupid, Pheonurse, Velvet, and Reddy) may be non-inferior to FC2, there were no available studies assessing their efficacy in preventing HIV and STIs. Conclusion The use of female plus male condoms is more effective than use of male condoms only in preventing STIs and may be as effective as the male condom only in preventing HIV. There is a need for well conducted studies assessing the effects of newer female condoms on HIV and STIs. PROSPERO registration number CRD42018090710en_US
dc.identifier.apacitationWiyeh, A. B., Mome, R. K. B., Mahasha, P. W., Kongnyuy, E. J., & Wiysonge, C. S. (2020). Effectiveness of the female condom in preventing HIV and sexually transmitted infections: a systematic review and meta-analysis. <i>BMC Public Health</i>, 20(1), 391. en_ZA
dc.identifier.chicagocitationWiyeh, Alison B, Ruth K B Mome, Phetole W Mahasha, Eugene J Kongnyuy, and Charles S Wiysonge "Effectiveness of the female condom in preventing HIV and sexually transmitted infections: a systematic review and meta-analysis." <i>BMC Public Health</i> 20, 1. (2020): 391. en_ZA
dc.identifier.citationWiyeh, A.B., Mome, R.K.B., Mahasha, P.W., Kongnyuy, E.J. & Wiysonge, C.S. 2020. Effectiveness of the female condom in preventing HIV and sexually transmitted infections: a systematic review and meta-analysis. <i>BMC Public Health.</i> 20(1):391. en_ZA
dc.identifier.issn1471-2458
dc.identifier.ris TY - Journal Article AU - Wiyeh, Alison B AU - Mome, Ruth K B AU - Mahasha, Phetole W AU - Kongnyuy, Eugene J AU - Wiysonge, Charles S AB - Abstract Background The effectiveness of female condoms for preventing HIV and sexually transmitted infections (STIs) remains inconclusive. We examined the effects of female condoms on the acquisition of HIV and STIs. Methods We searched four databases, two trial registries, and reference lists of relevant publications in October 2018 and updated our search in February 2020. We screened search output, evaluated study eligibility, and extracted data in duplicate; resolving differences through discussion. We calculated the effective sample size of cluster randomised trials using an intra-cluster correlation coefficient of 0·03. Data from similar studies were combined in a meta-analysis. We performed a non-inferiority analysis of new condoms relative to marketed ones using a non-inferiority margin of 3%. We assessed the certainty of evidence using GRADE. Results We included fifteen studies of 6921 women. We found that polyurethane female condoms (FC1) plus male condoms may be as effective as male condoms only in reducing HIV acquisition (1 trial, n = 149 women, RR 0.07, 95%CI 0.00–1.38; low-certainty evidence). However, the use of FC1 plus male condoms is superior to male condoms alone in reducing the acquisition of gonorrhoea (2 trials, n = 790, RR 0.59, 95%CI 0.41–0.86; high-certainty evidence) and chlamydia (2 trials, n = 790, RR 0.67, 95%CI 0.47–0.94; high-certainty evidence). Adverse events and failure rates of FC1 were very low and decreased during follow up. Although the functionality of newer female condoms (Woman’s, Cupid, Pheonurse, Velvet, and Reddy) may be non-inferior to FC2, there were no available studies assessing their efficacy in preventing HIV and STIs. Conclusion The use of female plus male condoms is more effective than use of male condoms only in preventing STIs and may be as effective as the male condom only in preventing HIV. There is a need for well conducted studies assessing the effects of newer female condoms on HIV and STIs. PROSPERO registration number CRD42018090710 DA - 2020-03-12 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Public Health KW - Female condom KW - HIV KW - Sexually transmitted infections KW - Systematic review LK - https://open.uct.ac.za PY - 2020 SM - 1471-2458 T1 - Effectiveness of the female condom in preventing HIV and sexually transmitted infections: a systematic review and meta-analysis TI - Effectiveness of the female condom in preventing HIV and sexually transmitted infections: a systematic review and meta-analysis UR - ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12889-020-8384-7
dc.identifier.urihttps://hdl.handle.net/11427/31631
dc.identifier.vancouvercitationWiyeh AB, Mome RKB, Mahasha PW, Kongnyuy EJ, Wiysonge CS. Effectiveness of the female condom in preventing HIV and sexually transmitted infections: a systematic review and meta-analysis. BMC Public Health. 2020;20(1):391. .en_ZA
dc.language.rfc3066en
dc.publisher.departmentDepartment of Public Health and Family Medicineen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s).
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceBMC Public Healthen_US
dc.source.journalissue1en_US
dc.source.journalvolume20en_US
dc.source.pagination391en_US
dc.source.urihttps://bmcpublichealth.biomedcentral.com/
dc.subjectFemale condomen_US
dc.subjectHIVen_US
dc.subjectSexually transmitted infectionsen_US
dc.subjectSystematic reviewen_US
dc.titleEffectiveness of the female condom in preventing HIV and sexually transmitted infections: a systematic review and meta-analysisen_US
dc.typeJournal Articleen_US
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