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Evaluating Services for Women Who Tested HIV-positive During the Phase 3 Trial

Council researchers evaluated the referrals for care and support provided to women who tested positive for HIV during the Council’s Phase 3 trial of Carraguard.

This project (formally titled "Evaluating the Strategies for Care and Support of Women Who Test Positive for HIV During the Phase 3 Study of the Efficacy and Safety of the Microbicide Carraguard®") assessed referrals for care in order to:

  • gauge whether the women accessed the services in the referral networks;
  • document reasons why the women used the services;
  • identify any barriers or challenges to accessing those services; and
  • understand the women’s needs and assess whether the referral services met those needs.

At each Phase 3 study site, staff developed specific strategies to ensure that women who tested positive were provided with referrals to local clinics, hospitals, and nongovernmental organizations for counseling, CD4 counts, and antiretroviral treatment, as necessary.

The Population Council conducted a qualitative research study at the three clinical trial sites in South Africa—the Setshaba Research Centre in Soshanguve (University of Limpopo/Medunsa campus), the Empilisweni Centre for Wellness Studies in Gugulethu (University of Cape Town), and the Isipingo Clinic (South African Medical Research Council, Durban). This study documented the referrals made and assessed the participants’ use of and satisfaction with these referrals.

The study consisted of in-depth interviews with HIV-positive women and a survey among providers and program staff in the established “referral network.”

Researchers conducted the interviews with 20–30 women at each site within ten to twelve weeks of their HIV-positive diagnoses. Researchers also conducted a survey among providers (including doctors, nurses, and counselors, as applicable) in the established “referral network” facilities to document the number of clients referred to each facility, identify the availability and use of different types of services that are offered at these facilities, and assess how referrals from the Phase 3 study contributed to the caseloads at these facilities.

A better understanding of the use and quality of services provided in referral networks will provide valuable data for the modification or revision of strategies for providing care and support for HIV-positive participants in this trial as well as other trials of HIV-prevention technologies.

A randomized, placebo-controlled trial to assess the safety and acceptability of use of Carraguard vaginal gel by heterosexual couples in Thailand (abstract
Kilmarx,Peter H.; Blanchard,Kelly; Chaikummao,Supaporn; Friedland,Barbara A.; Srivirojana,Nucharee; Connolly,Cathy; Witwatwongwana,Paisit; Supawitkul,Somsak; Mock,Philip A.; Chaowanachan,Thanyanan; Tappero,Jordan W.
Sexually Transmitted Diseases 35(3): 226-232
Publication date: 2008


Consentement éclairé dans les essais de prévention du VIH: Points saillants d'un atelier international [Informed consent in HIV prevention trials: Highlights from an international workshop] (PDF
Publication date: 2008


Consentimento informado nos ensaios de prevenção do HIV: Pontos altos dum workshop internacional [Informed consent in HIV prevention trials: Highlights from an international workshop] (PDF
Publication date: 2008


Consentimiento informado en ensayos de prevención del VIH: Aspectos destacados de un taller internacional [Informed consent in HIV prevention trials: Highlights from an international workshop] (PDF
Publication date: 2008


Differentiating normal from abnormal rates of genital epithelial findings in vaginal microbicide trials (abstract
van de Wijgert,Janneke; Kilmarx,Peter H.; Jones,Heidi E.; Karon,John M.; Chaikummao,Supaporn
Contraception 77(2): 122-129
Publication date: 2008


Efficacy of Carraguard for prevention of HIV infection in women in South Africa: A randomised, double-blind, placebo-controlled trial (abstract
Skoler-Karpoff,Stephanie; Ramjee,Gita; Ahmed,Khatija; Altini,Lydia; Gehret,Marlena; Friedland,Barbara A.; Govender,Sumentheran N.; de Kock,Alana; Cassim,Nazira; Palanee,Thesla; Dozier,Gregory; Maguire,Robin A.; Lahteenmaki,Pekka
Lancet 372(9654): 1977-1987
Publication date: 2008


Efficacy of Carraguard-based microbicides in vivo despite variable in vitro activity (abstract) (PDF
Turville,Stuart G.; Aravantinou,Meropi; Miller,Todd; Kenney,Jessica; Teitelbaum,Aaron; Hu,Lieyu; Chudolij,Anne; Zydowsky,Thomas M.; Piatak Jr.,Michael; Bess Jr.,Julian W.; Lifson,Jeffrey D.; Blanchard,James; Gettie,Agegnehu; Robbiani,Melissa
PLoS ONE 3(9): e3162-
Publication date: 2008


Idhini fahamishi katika majaribio ya kikliniki ya ukingaji wa virusi vya ukimwi [Informed consent in HIV prevention trials: Highlights from an international workshop] (PDF
Publication date: 2008


Imvume unolwazi ocwaningweni lokuvimbela igciwane lesandulela ngculaza [Informed consent in HIV prevention trials: Highlights from an international workshop] (PDF
Publication date: 2008


Informed consent in HIV prevention trials: Highlights from an international workshop (PDF
Publication date: 2008


Microbicide product development (abstract
Maguire,Robin A.
Current Opinion in HIV and AIDS 3(5): 554-557
Publication date: 2008


Microbicides: Chemistry, structure, and strategy (abstract
Zydowsky,Thomas M.
Current Opinion in HIV and AIDS 3(5): 548-553
Publication date: 2008


No increase in cervicovaginal proinflammatory cytokines after Carraguard use in a placebo-controlledrandomized clinical trial (abstract
Bollen,Liesbeth J.M.; Blanchard,Kelly; Kilmarx,Peter H.; Chaikummao,Supaporn; Connolly,Cathy; Wasinrapee,Punneporn; Srivirojana,Nucharee; Achalapong,Jullapong; Tappero,Jordan W.; McNicholl,Janet M.
Journal of Acquired Immune Deficiency Syndromes 47(2): 253-257
Publication date: 2008


Carrageenan/MIV-150 (PC-815), a combination microbicide (abstract) (HTML
Fernandez-Romero,Jose A.; Thorn,Mitchell; Turville,Stuart G.; Titchen,Kanani; Sudol,Kristin M.; Li,Jifan; Miller,Todd; Robbiani,Melissa; Maguire,Robin A.; Buckheit Jr.,Robert W.; Hartman,Tracy L.; Phillips,David M.
Sexually Transmitted Diseases 34(1): 9-14
Publication date: 2007


Acceptability of Carraguard, a candidate microbicide and methyl cellulose placebo vaginal gels among HIV-positive women and men in Durban, South Africa (abstract) (PDF
Ramjee,Gita; Morar,Neetha S.; Braunstein,Sarah; Friedland,Barbara A.; Jones,Heidi E.; van de Wijgert,Janneke
AIDS Research and Therapy 4(20)
Publication date: 2007


Carraguard vaginal gel safety in HIV-positive women and men in South Africa (abstract
van de Wijgert,Janneke; Braunstein,Sarah; Morar,Neetha S.; Jones,Heidi E.; Madurai,Lorna; Evans Strickfaden,Tammy T.; Moodley,Manivasan; Aboobaker,Jamila; Ndlovu,Gugulethu; Ferguson,Taja M.; Friedland,Barbara A.; Hart,Clyde E.; Ramjee,Gita
Journal of Acquired Immune Deficiency Syndromes 46(5): 538-546
Publication date: 2007


Day of dialogue--Insights and evidence from product introduction: Lessons for microbicides (PDF
Brady,Martha; McGrory,C.Elizabeth
Publication date: 2007


Determining the feasibility of utilizing the microbicide applicator compliance assay for use in clinical trials (abstract
Wallace,Andrea R.; Teitelbaum,Aaron; Wan,Livia; Mulima,Maria Gloria; Guichard,Laura; Skoler,Stephanie; Vilakazi,Hlengiwe; Mapula,Fridda S.; Rossier,Jasmine; Govender,Sumentheran N.; Lahteenmaki,Pekka; Maguire,Robin A.; Phillips,David M.
Contraception 76(1): 53-56
Publication date: 2007


Effect of a single vaginal administration of levonorgestrel in Carraguard® gel on the ovulatory process: A potential candidate for 'dual protection' emergency contraception (abstract
Brache,Vivian; Croxatto,Horacio B.; Sitruk-Ware,Regine; Maguire,Robin A.; Montero,Juan Carlos; Kumar,Narender; Salvatierra,Ana Maria; Tejada,Ana-Sofia; Cochon,Leila; Forcelledo,Maria Luisa; Lahteenmaki,Pekka; Alvarez,Francisco; Faundes,Anibal
Contraception 76(2): 111-116
Publication date: 2007


Engaging advocates from concept to results: Summary report of the Advocates' Consultation on HIV Prevention Trials: Carraguard and VOICE Studies, Johannesburg, South Africa, 18-19 October 2007 (PDF
Meeting report
Publication date: 2007


Pharmacokinetic study to compare the absorption and tolerability of two doses of levonorgestrel following single vaginal administration of levonorgestrel in Carraguard® gel: A new formulation for 'dual protection' contraception (abstract
Sitruk-Ware,Regine; Brache,Vivian; Maguire,Robin A.; Croxatto,Horacio B.; Kumar,Narender; Kumar,Sushma; Montero,Juan Carlos; Salvatierra,Ana Maria; Phillips,David M.; Faundes,Anibal
Contraception 75(6): 454-460
Publication date: 2007


Tests suggest new microbicide will have improved efficacy (PDF
Population Briefs 13(2)
Publication date: 2007


Acceptability of Carraguard vaginal gel use among Thai couples (abstract
Whitehead,Sara J.; Kilmarx,Peter H.; Blanchard,Kelly; Manopaiboon,Chomnad; Chaikummao,Supaporn; Friedland,Barbara A.; Achalapong,Jullapong; Wankrairoj,Mayuree; Mock,Philip A.; Thanprasertsuk,Sombat; Tappero,Jordan W.
AIDS 20(17): 2141-2148
Publication date: 2006


Challenges in microbicide trial design and implementation (PDF
van de Wijgert,Janneke; Jones,Heidi E.
Studies in Family Planning 37(2): 123-129
Publication date: 2006


Challenges to microbicide introduction in South Africa (abstract
Orner,Phyllis; Harries,Jane; Cooper,Diane; Moodley,Jennifer; Hoffman,Margaret; Becker,Julie; McGrory,C.Elizabeth; Dabash,Rasha; Bracken,Hillary J.
Social Science and Medicine 63(4): 968-978
Publication date: 2006


Informed Consent in HIV Prevention Trials: Report of an International Workshop (PDF
McGrory,C.Elizabeth; Friedland,Barbara A.; Woodsong,Cynthia; MacQueen,Kathleen M.
Publication date: 2006


Our current microbicide trials: Lessons learned and to be learned (PDF
Skoler,Stephanie; Peterson,Leigh; Cates,Ward
The Microbicide Quarterly 4(1): 1-6
Publication date: 2006


Phase 3 study of the efficacy and safety of the microbicide Carraguard in preventing HIV seroconversion in women (Population Council Protocol 322): Summary (PDF
Population Council
Publication date: 2006


Phase 3 study of the efficacy and safety of the microbicide Carraguard in preventing HIV seroconversion in women: Protocol synopsis (PDF
Population Council
Publication date: 2006


Safety and acceptability of the candidate microbicide Carraguard in Thai women: Findings from a Phase II clinical trial (abstract
Kilmarx,Peter H.; van de Wijgert,Janneke; Chaikummao,Supaporn; Jones,Heidi E.; Limpakarnjanarat,Kanchit; Friedland,Barbara A.; Karon,John M.; Manopaiboon,Chomnad; Srivirojana,Nucharee; Yanpaisarn,Somboonsak; Supawitkul,Somsak; Young,Nancy L.; Mock,Philip A.; Blanchard,Kelly; Mastro,Timothy D.
Journal of Acquired Immune Deficiency Syndromes 43(3): 327-334
Publication date: 2006


Slamming the door on unwanted guests: Why preemptive strikes at the mucosa may be the best strategy against HIV (abstract
Trapp,Susanna; Turville,Stuart G.; Robbiani,Melissa
Journal of Leukocyte Biology 80(5): 1076-1083
Publication date: 2006


Microbicides: Developing and testing a gel to prevent HIV transmission (PDF
Population Council Annual Report 2004
Publication date: 2005


Microbicides: Developing and testing a gel to prevent HIV transmission [Arabic] (PDF
Population Council Annual Report 2004
Publication date: 2005


Phase III microbicide trial methodology: Opinions of experienced expanded safety trial participants in South Africa (abstract
van de Wijgert,Janneke; Jones,Heidi E.; Pistorius,Annalie; de Kock,Alana; Sebola,Mohlatlego H.; Friedland,Barbara A.; Hoosen,Anwar; Coetzee,Nicol
Journal of Social Aspects of HIV/AIDS 2(3): 311-319
Publication date: 2005


Preferences and practices related to vaginal lubrication: Implications for microbicide acceptability and clinical testing (abstract
Braunstein,Sarah; van de Wijgert,Janneke
Journal of Women's Health 14(5): 424-433
Publication date: 2005


Assay for establishing whether microbicide applicators have been exposed to the vagina (abstract
Wallace,Andrea R.; Thorn,Mitchell; Maguire,Robin A.; Sudol,Kristin M.; Phillips,David M.
Sexually Transmitted Diseases 31(8): 465-468
Publication date: 2004


Carraguard may block HIV by adhering to cells (PDF
Population Briefs 10(1)
Publication date: 2004


Lubricants containing N-9 may enhance rectal transmission of HIV and other STIs (abstract
Phillips,David M.; Sudol,Kristin M.; Taylor,Clark L.; Guichard,Laura; Elsen,Robert; Maguire,Robin A.
Contraception 70(2): 107-110
Publication date: 2004


Microbicide trials for preventing HIV/AIDS in South Africa: Phase II trial participants' experiences and psychological needs (abstract
Pistorius,Annalie; van de Wijgert,Janneke; Sebola,Mohlatlego H.; Friedland,Barbara A.; Nagel,Evelyn; Bokaba,Cathleen; Hoosen,Anwar
Journal of Social Aspects of HIV/AIDS 1(2): 78-86
Publication date: 2004


Paving the Path: Preparing for Microbicide Introduction-Report of a Qualitative Study in South Africa (PDF
Becker,Julie; Dabash,Rasha; McGrory,C.Elizabeth; Cooper,Diane; Harries,Jane; Hoffman,Margaret; Moodley,Jennifer; Orner,Phyllis; Bracken,Hillary J.
Publication date: 2004


Relative safety of sexual lubricants for rectal intercourse (abstract) (PDF
Sudol,Kristin M.; Phillips,David M.
Sexually Transmitted Diseases 31(6): 346-349
Publication date: 2004


Testing Carraguard: What you need to know (PDF
Clacherty,Glynis; Friedland,Barbara A.; de Kock,Alana; Marumo,Mabitso
Publication date: 2004


Carrageenan formulation prevents macrophage trafficking from vagina: Implications for microbicide development (abstract) (PDF
Perotti,Maria-Elisa; Pirovano,Alessia; Phillips,David M.
Biology of Reproduction 69(3): 933-939
Publication date: 2003


Cultural norms and behavior regarding vaginal lubrication during sex: Implications for the acceptability of vaginal microbicides for the prevention of HIV/STIs (PDF
Braunstein,Sarah; van de Wijgert,Janneke
Robert H. Ebert Program on Critical Issues in Reproductive Health Publication Series
Publication date: 2003


Female condoms and microbicides 
Esu-Williams,Eka; Blanchard,Kelly; Essex,Max; Mboup,Souleymane; Kanki,Phyllis J.; Marlink,Richard G.; Tlou,Sheila D.
from AIDS in Africa, pp. 506-513
Publication date: 2002


Informed consent: From good intentions to sound practices--A report of a seminar (PDF
Wood,Susan Y.; Friedland,Barbara A.; McGrory,C.Elizabeth
Robert H. Ebert Program on Critical Issues in Reproductive Health Publication Series
Publication date: 2002


Microbicides to prevent heterosexual transmission of HIV: Ten years down the road (HTML
van de Wijgert,Janneke; Coggins,Christiana
Bulletin of Experimental Treatments for AIDS 15(2): 23-28
Publication date: 2002


Motivations for and barriers to study participation (PDF
Population Briefs 8(1)
Publication date: 2002


Non-HIV STIs and the epidemiology of success 
Blanchard,Kelly; Elias,Christopher J.
from The Science of Microbicides: Accelerating Development, report of the Science Working Group of the Microbicide Initiative, pp. 47-51
Publication date: 2002


Nonoxynol-9 rapidly exfoliates rectal epithelium (PDF
Population Briefs, Spring 2002 (HIV/AIDS edition)
Publication date: 2002


Acceptability and feasibility of Micralax applicators and of methyl cellulose gel placebo for large-scale clinical trials of vaginal microbicides (abstract) (PDF
Coetzee,Nicol; Blanchard,Kelly; Ellertson,Charlotte; Hoosen,Anwar; Friedland,Barbara A.
AIDS 15(14): 1837-1842
Publication date: 2001


Acceptability research on female-controlled barrier methods to prevent heterosexual transmission of HIV: Where have we been? Where are we going? (abstract
Elias,Christopher J.; Coggins,Christiana
Journal of Women's Health and Gender-Based Medicine 10(2): 163-173
Publication date: 2001


Phase 1 trial of the topical microbicide BufferGel: Safety results from four international sites (abstract
van de Wijgert,Janneke; Fullem,Andrew; Kelly,Clifton A.; Mehendale,Sajay; Rugpao,Sungwal; Kumwenda,Newton; Chirenje,Zvavahera M.; Joshi,Mita; Taha,Taha; Padian,Nancy F.; Bollinger,Robert; Nelson,Kenrad
Journal of Acquired Immune Deficiency Syndromes 26(1): 21-27
Publication date: 2001


Recommendations for the clinical development of topical microbicides: An update (abstract) (PDF
Mauck,Christine; Rosenberg,Zeda; Van Damme,Lut; van Dam,C.Johannes
AIDS 15(7): 857-868
Publication date: 2001


The case for microbicides: A global priority. Second edition (PDF
Attawell,Kathy
Publication date: 2001


Women's willingness to participate in microbicide trials in northern Thailand (abstract
Kanokwan,Tharawan; Manopaiboon,Chomnad; Ellertson,Charlotte; Limpakarnjanarat,Kanchit; Chaikummao,Supaporn; Kilmarx,Peter H.; Blanchard,Kelly; Coggins,Christiana; Mastro,Timothy D.; Elias,Christopher J.
Journal of Acquired Immune Deficiency Syndromes 28(2): 180-186
Publication date: 2001


Men's attitudes toward vaginal product use: Farmers and taxi drivers in Mexico 
Coggins,Christiana; Madrigal,Mauricio Ramos; Llamas,Alicia
Publication date: 2000


Men's attitudes towards a potential vaginal microbicide in Zimbabwe, Mexico and the USA (abstract
Coggins,Christiana; Blanchard,Kelly; Friedland,Barbara A.
Reproductive Health Matters 8(15): 132-141
Publication date: 2000


Preliminary safety and acceptability of a carrageenan gel for possible use as a vaginal microbicide (abstract
Coggins,Christiana; Blanchard,Kelly; Alvarez,Francisco; Brache,Vivian; Weisberg,Edith; Kilmarx,Peter H.; Lacarra,Maria; Massai,Rebeca; Mishell,Daniel R.,Jr.; Salvatierra,Ana Maria; Witwatwongwana,Paisit; Elias,Christopher J.; Ellertson,Charlotte
Sexually Transmitted Infections 76(6): 480-483
Publication date: 2000


Informing Research on HIV Prevention: A Consultation (PDF
Fonn,Sharon; McGrory,C.Elizabeth
Publication date: 1999


Pushing the frontiers of science-the Population Council's Microbicide Basic Science Network on vaginal microbicide research (abstract
Johansson,Elof D.B.; Maguire,Robin A.; Phillips,David M.
International Journal of Gynecology and Obstetrics 67(suppl 2): 117-124
Publication date: 1999


A study of women's preferences regarding the formulation of over-the-counter vaginal spermicides (PDF
Coggins,Christiana; Elias,Christopher J.; Atisook,Ronachai; Bassett,Mary T.; Ettiegne-Traore,Virginie; Ghys,Peter D.; Jenkins-Woelk,Laura; Thongkrajai,Earmporn; VanDevanter,Nancy L.
Robert H. Ebert Program on Critical Issues in Reproductive Health Publication Series
Publication date: 1998


Practical and ethical dilemmas in the clinical testing of microbicides: A report on a symposium 
Heise,Lori L.; McGrory,C.Elizabeth; Wood,Susan Y.
Publication date: 1998


The development of microbicides: A new method of HIV prevention for women (PDF
Elias,Christopher J.; Heise,Lori L.
Programs Division Working Paper (no. 6)
Publication date: 1993


 

Project Stats

Location: South Africa (Gugulethu, Isipingo, Soshanguve) 

Program(s): HIV and AIDS 

Topic(s): HIV care, support, and treatment
Microbicides
Monitoring and evaluation

Duration: 4/2006 - 6/2007

Population Council researchers:
Barbara Friedland

Non-Council collaborators:
Jane Harries  (Women’s Health Research Unit, University of Cape Town)
Khatija Ahmed  (University of Limpopo/Medunsa Campus)
Nazira Cassim  (University of Limpopo/Medunsa campus, Soshanguve)
Neetha Morar  (HIV Prevention Research Unit, South African Medical Research Council, Durban)
Smruti Patel  (Women’s Health Research Unit, University of Cape Town)
Thesla Palanee  (HIV Prevention Research Unit, South African Medical Research Council, Durban)
Vuyelwa Mtimkulu  (University of Limpopo/Medunsa campus, Soshanguve)

Donors:
International Partnership for Microbicides
US Agency for International Development

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