{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:48:36Z","timestamp":1792093716470,"version":"4.4.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T00:00:00Z","timestamp":1702512000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UM1AI068633"],"award-info":[{"award-number":["UM1AI068633"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UM1AI068615"],"award-info":[{"award-number":["UM1AI068615"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UM1AI106707"],"award-info":[{"award-number":["UM1AI106707"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32AI007140"],"award-info":[{"award-number":["T32AI007140"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Eunice Kennedy Shriver"},{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Confounding introduced by individuals\u2019 sexual risk behavior is potentially a significant source of bias in HIV-1 prevention intervention studies. To more completely account for sexual behaviors when assessing the efficacy of the monthly dapivirine ring, a new longer-acting HIV-1 prevention option for women, we estimated per-sex-act risk reduction associated with product use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a secondary analysis of data from MTN-020\/ASPIRE, a phase 3, randomized, placebo-controlled efficacy trial of the dapivirine ring that recruited HIV-uninfected, African women aged 18\u201345 years. With cumulative sex acts as the time scale, we used multivariable Cox regression with inverse probability of censoring weights to estimate HIV-1 risk reduction associated with a rate of dapivirine release indicative of consistent product use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Women in the dapivirine ring group (n = 1187) had an estimated incidence rate of 2.3 (95% confidence interval [CI], 1.8\u20133.1) HIV-1 acquisition events per 10 000 sex acts versus 3.6 (95% CI, 2.9\u20134.4) per 10 000 acts in the placebo group (n = 1187). Dapivirine release indicative of consistent ring use was associated with a 63% (95% CI, 33%\u201380%) per-sex-act HIV-1 risk reduction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These results support the efficacy of the dapivirine vaginal ring for HIV-1 prevention and help to inform decision-making for women, providers, and policymakers regarding product use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Trials Registration<\/jats:title>\n                  <jats:p>NCT01617096.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiad550","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T12:12:28Z","timestamp":1702642348000},"page":"1158-1165","source":"Crossref","is-referenced-by-count":4,"title":["Assessing Per-Sex-Act HIV-1 Risk Reduction Among Women Using the Dapivirine Vaginal Ring"],"prefix":"10.1093","volume":"229","author":[{"given":"Randy M","family":"Stalter","sequence":"first","affiliation":[{"name":"Department of Epidemiology, University of Washington , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy Q","family":"Dong","sequence":"additional","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig W","family":"Hendrix","sequence":"additional","affiliation":[{"name":"Department of Medicine, Johns Hopkins University , Baltimore, MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thesla","family":"Palanee-Phillips","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Washington , Seattle, WA , USA"},{"name":"Wits Reproductive Health and HIV Research Institute, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariane","family":"van der Straten","sequence":"additional","affiliation":[{"name":"Center for AIDS Prevention Studies, Department of Medicine, University of California San Francisco , San Francisco, CA , USA"},{"name":"ASTRA consulting , Kensington, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon L","family":"Hillier","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine , Pittsburgh, PA , USA"},{"name":"Magee-Womens Research Institute , Pittsburgh, PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia M","family":"Kiweewa","sequence":"additional","affiliation":[{"name":"Research Department, Makerere University-Johns Hopkins University Research Collaboration , Kampala , Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nyaradzo M","family":"Mgodi","sequence":"additional","affiliation":[{"name":"Clinical Trials Research Centre, University of Zimbabwe , Harare , Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A","family":"Marzinke","sequence":"additional","affiliation":[{"name":"Department of Medicine, Johns Hopkins University , Baltimore, MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda-Gail","family":"Bekker","sequence":"additional","affiliation":[{"name":"The Desmond Tutu HIV Centre, University of Cape Town , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Soto-Torres","sequence":"additional","affiliation":[{"name":"Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health , Bethesda, MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared M","family":"Baeten","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Washington , Seattle, WA , USA"},{"name":"Departments of Medicine and Global Health, University of Washington , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth R","family":"Brown","sequence":"additional","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center , Seattle, WA , USA"},{"name":"Department of Biostatistics, University of Washington , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the MTN-020\/ASPIRE Study 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