{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T14:04:30Z","timestamp":1787321070515,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,5,13]],"date-time":"2020-05-13T00:00:00Z","timestamp":1589328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the evidence on the effectiveness of vaginal microbicides in preventing HIV transmission in women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Systematic review through a comprehensive search of relevant electronic databases for eligible randomised controlled trials (RCTs) published through June 2019. Two authors independently screened titles and abstracts according to eligibility criteria, then extracted data and assessed risk of bias of included studies. We conducted a random\u2010effects meta\u2010analysis of risk ratios (RR) of HIV infection and assessed heterogeneity using chi\u2010squared and\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      tests. Sources of heterogeneity were investigated through subgroup analysis, publication bias was assessed using funnel plots, and certainty of evidence was graded using GRADEPro software.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 18 RCTs which enrolled 40,048 sexually active, HIV\u2010negative, non\u2010pregnant women, aged 16\u00a0years and older, mainly from sub\u2010Saharan Africa. The intravaginal ring containing dapivirine significantly reduced HIV risk by 29% (RR 0.71, 95% CI: 0.57\u20130.89; 2 RCTs, 4,564 women, moderate certainty of evidence). Estimates of effect of tenofovir 1% (RR 0.83, 95% CI: 0.65\u20131.06), nonoxynol\u20109 (RR 1.15, 95% CI: 0.93\u20131.42), cellulose sulphate (RR 1.16, 95% CI: 0.61\u20132.21), SAVVY (RR 1.34, 95% CI: 0.69\u20132.59), Carraguard (RR 0.89, 95% CI: 0.71\u20131.10), BufferGel (RR 1.02, 95% CI: 0.71\u20131.46), 0.5% PRO2000 (RR 0.88, 95% CI: 0.60\u20131.28) and 2% PRO2000 (RR 0.81, 95% CI: 0.58\u20131.12) failed to reach statistical significance; each had low certainty of evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The long\u2010acting intravaginal ring containing dapivirine significantly reduced risk of HIV transmission in women by 29%. The remaining microbicides had no evident effect.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tmi.13401","type":"journal-article","created":{"date-parts":[[2020,4,19]],"date-time":"2020-04-19T03:35:35Z","timestamp":1587267335000},"page":"790-802","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Effectiveness of vaginal microbicides in preventing HIV transmission"],"prefix":"10.1111","volume":"25","author":[{"given":"Alfred","family":"Musekiwa","sequence":"first","affiliation":[{"name":"Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore MD USA"},{"name":"School of Health Systems and Public Health University of Pretoria Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimasha B.","family":"Fernando","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health University of Maryland School of Medicine Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel A.","family":"Abariga","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,13]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"UNAIDS.2017 Global HIV Statistics(Available from:http:\/\/www.unaids.org\/en\/resources\/fact\u2010sheet)."},{"key":"e_1_2_7_3_1","unstructured":"CDC.Pre\u2010Exposure Prophylaxis (PrEP) 2019(Available from:https:\/\/www.cdc.gov\/hiv\/risk\/prep\/index.html)."},{"key":"e_1_2_7_4_1","unstructured":"WHO.Microbicides(Available from:https:\/\/www.who.int\/hiv\/topics\/microbicides\/microbicides\/en\/)."},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-12-289"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1992.03490040053025"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199808203390803"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.9.1117"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)11079-8"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0001474"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0001312"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707957"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0003784"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61842-5"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32834541d9"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61086-0"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30428-6"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602046"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1506110"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1402269"},{"key":"e_1_2_7_21_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins JP","year":"2006"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_7_23_1","volume-title":"Covidence Systematic Review Software","author":"Innovation V","year":"2017"},{"key":"e_1_2_7_24_1","unstructured":"Collaboration C.Review Manager (RevMan) [5.3. 5]. Oxford;2015."},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.04.026"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-200107000-00006"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2010.04.019"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1193748"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.virol.2016.07.004"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.antiviral.2009.10.013"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(08)70254-8"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/095632020901900401"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.med.59.061206.112737"},{"key":"e_1_2_7_34_1","first-page":"1231","article-title":"Microbicides in the prevention of HIV infection: current status and future directions","volume":"70","author":"Nuttall J","year":"2010","journal-title":"Drugs"},{"key":"e_1_2_7_35_1","first-page":"Cd007961","article-title":"Topical microbicides for prevention of sexually transmitted infections","volume":"6","author":"Obiero J","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_36_1","unstructured":"IPM.Final Results of Open\u2010label Study of IPM\u2019s Dapivirine Vaginal Ring Show Increased Use and Suggest Lower Infection Rates Compared to Earlier Phase III Study 2019. (Available from:https:\/\/www.ipmglobal.org\/content\/final\u2010results\u2010open\u2010label\u2010study\u2010ipm%E2%80%99s\u2010dapivirine\u2010vaginal\u2010ring\u2010show\u2010increased\u2010use\u2010and\u2010suggest) [10 Mar 2020]."}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftmi.13401","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.13401","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tmi.13401","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.13401","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T21:56:09Z","timestamp":1693950969000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.13401"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,13]]},"references-count":35,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1111\/tmi.13401"],"URL":"https:\/\/doi.org\/10.1111\/tmi.13401","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,13]]},"assertion":[{"value":"2020-05-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}