{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T05:11:39Z","timestamp":1772514699833,"version":"3.50.1"},"reference-count":40,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T00:00:00Z","timestamp":1612396800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"International Partnership for Microbicides","award":["IND # 110,659"],"award-info":[{"award-number":["IND # 110,659"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2021,1,7]]},"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Participation in HIV prevention trials could trigger risk compensation among participants. We evaluated potential risk compensation following use of a vaginal ring microbicide by women in a phase III trial in southwestern Uganda.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used markers of sexual risk behaviour documented on standardised questionnaires, tested for STIs at baseline and quarterly for 2 years. Risk compensation was defined as a significant increase (trend p&lt;0.05) in the proportion of women reporting risky sexual behaviour or a diagnosed STI between baseline and end of follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between September 2013 and December 2016, 197 women (active arm: n=132\u2009and placebo: n=65) were enrolled at the Masaka site. There were decreases in all markers of sexual risk behaviour with statistically significant decreases in only the proportion of women reporting \u22652 sexual partners, p=0.026\u2009and those diagnosed with<jats:italic>Trichomonas vaginalis<\/jats:italic>p&lt;0.001\u2009and or<jats:italic>Neisseria gonorrhoeae<\/jats:italic>p&lt;0.001<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>No evidence of risk compensation was observed in this trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT01539226\">NCT01539226<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2020-054718","type":"journal-article","created":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T13:27:11Z","timestamp":1612531631000},"page":"32-37","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Assessment of risk compensation following use of the dapivirine vaginal ring in southwestern Uganda"],"prefix":"10.1136","volume":"98","clinical-trial-number":[{"clinical-trial-number":"nct01539226","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1390-109X","authenticated-orcid":false,"given":"Sylvia","family":"Kusemererwa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Abaasa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Kabarambi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Onyango","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph Okello","family":"Mugisha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,2,4]]},"reference":[{"key":"2024092104001284000_98.1.32.1","unstructured":"UNAIDS . Factsheet: global AIDS update. 2019: UNAIDS Geneva, 2019. Available: https:\/\/www.unaids.org\/en\/resources\/documents\/2019\/UNAIDS_FactSheet [Accessed 27 Jun 2019]."},{"key":"2024092104001284000_98.1.32.2","unstructured":"Unaids GH, statistics A. 2018 fact sheet, 2019, 2019. Available: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/unaids-data-2019_en.pdf [Accessed 27 Jun 2019]."},{"key":"2024092104001284000_98.1.32.3","unstructured":"UNAIDS . Women and HIV \u2014 a spotlight on adolescent girls and young women: UNAIDS, 2019. Available: https:\/\/www.unaids.org\/en\/resources\/documents\/2019\/women-and-hiv [Accessed 27 Jun 2019]."},{"key":"2024092104001284000_98.1.32.4","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/S2055-6640(20)30458-1","article-title":"Hiv pre-exposure prophylaxis for women","volume":"2","author":"Sheth","year":"2016","journal-title":"J Virus Erad"},{"key":"2024092104001284000_98.1.32.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1402269"},{"key":"2024092104001284000_98.1.32.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602046"},{"key":"2024092104001284000_98.1.32.7","doi-asserted-by":"crossref","first-page":"2121","DOI":"10.1056\/NEJMoa1506110","article-title":"Use of a vaginal ring containing dapivirine for HIV-1 prevention in women","volume":"375","author":"Baeten","year":"2016","journal-title":"N Engl J Med Overseas Ed"},{"key":"2024092104001284000_98.1.32.8","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.332.7541.605"},{"key":"2024092104001284000_98.1.32.9","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-007-0024-7"},{"key":"2024092104001284000_98.1.32.10","doi-asserted-by":"crossref","DOI":"10.1097\/OLQ.0b013e31818eb752","article-title":"Disinhibition and risk compensation: scope, definitions, and perspective","volume":"35","author":"Hogben","year":"2008","journal-title":"Sex Transm Dis"},{"key":"2024092104001284000_98.1.32.11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0012366"},{"key":"2024092104001284000_98.1.32.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)09109-6"},{"key":"2024092104001284000_98.1.32.13","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.2.224"},{"key":"2024092104001284000_98.1.32.14","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws179"},{"key":"2024092104001284000_98.1.32.15","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0081997"},{"key":"2024092104001284000_98.1.32.16","doi-asserted-by":"crossref","DOI":"10.1097\/QAI.0b013e3182920126","article-title":"Racial differences and correlates of potential adoption of preexposure prophylaxis: results of a national survey","volume":"63 Suppl 1","author":"Wingood","year":"2013","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2024092104001284000_98.1.32.17","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2009.1576"},{"key":"2024092104001284000_98.1.32.18","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1007\/s10461-016-1627-z","article-title":"Values and preferences on the use of oral pre-exposure prophylaxis (PreP) for HIV prevention among multiple populations: a systematic review of the literature","volume":"21","author":"Koechlin","year":"2017","journal-title":"AIDS Behav"},{"key":"2024092104001284000_98.1.32.19","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-007-0024-7"},{"key":"2024092104001284000_98.1.32.20","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.1097\/QAI.0000000000001885","article-title":"Sexual risk compensation in a pre-exposure prophylaxis demonstration study among individuals at risk of HIV","volume":"80","author":"Milam","year":"2019","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2024092104001284000_98.1.32.21","doi-asserted-by":"crossref","DOI":"10.1097\/QAI.0000000000001604","article-title":"Pre-Exposure prophylaxis (PreP) use and condomless anal sex: evidence of risk compensation in a cohort of young men who have sex with men","volume":"77","author":"Newcomb","year":"2018","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2024092104001284000_98.1.32.22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0020684"},{"key":"2024092104001284000_98.1.32.23","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/s10461-018-2177-3","article-title":"Contraceptive preference among women at risk of HIV acquisition in a preparatory screening study for a phase III microbicide trial in South Western Uganda","volume":"22","author":"Kusemererwa","year":"2018","journal-title":"AIDS Behav"},{"key":"2024092104001284000_98.1.32.24","unstructured":"STD Control Unit of the STD\/AIDS Control programme . Ministry of health U. Uganda national guidelines for the syndromic management of sexually transmitted infections 2010."},{"key":"2024092104001284000_98.1.32.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2011.04.006"},{"key":"2024092104001284000_98.1.32.26","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1097\/OLQ.0b013e3181812939","article-title":"Changes in sexual risk behavior among participants in a PreP HIV prevention trial","volume":"35","author":"Guest","year":"2008","journal-title":"Sex Transm Dis"},{"key":"2024092104001284000_98.1.32.27","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pctr.0020027"},{"key":"2024092104001284000_98.1.32.28","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e31828f097a"},{"key":"2024092104001284000_98.1.32.29","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1110711"},{"key":"2024092104001284000_98.1.32.30","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1056\/NEJMoa1108524","article-title":"Antiretroviral prophylaxis for HIV prevention in heterosexual men and women","volume":"367","author":"Baeten","year":"2012","journal-title":"N Engl J Med Overseas Ed"},{"key":"2024092104001284000_98.1.32.31","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1056\/NEJMoa1202614","article-title":"Preexposure prophylaxis for HIV infection among African women","volume":"367","author":"Van Damme","year":"2012","journal-title":"N Engl J Med Overseas Ed"},{"key":"2024092104001284000_98.1.32.32","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60313-4"},{"key":"2024092104001284000_98.1.32.33","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0002443"},{"key":"2024092104001284000_98.1.32.34","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000143600.41363.78"},{"key":"2024092104001284000_98.1.32.35","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1080\/09540121.2011.596516","article-title":"A qualitative study of sexual behavior change and risk compensation following adult male circumcision in urban Swaziland","volume":"24","author":"Grund","year":"2012","journal-title":"AIDS Care"},{"key":"2024092104001284000_98.1.32.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61086-0"},{"key":"2024092104001284000_98.1.32.37","doi-asserted-by":"crossref","DOI":"10.1186\/1758-2652-13-39","article-title":"Change in condom and other barrier method use during and after an HIV prevention trial in Zimbabwe","volume":"13","author":"van der Straten","year":"2010","journal-title":"J Int AIDS Soc"},{"key":"2024092104001284000_98.1.32.38","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1080\/09540121.2011.630343","article-title":"Changes in condom use during a microbicide clinical trial in Pune, India","volume":"24","author":"Marlow","year":"2012","journal-title":"AIDS Care"},{"key":"2024092104001284000_98.1.32.39","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-018-0601-5"},{"key":"2024092104001284000_98.1.32.40","doi-asserted-by":"publisher","DOI":"10.1126\/science.1193748"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2020-054718","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,21]],"date-time":"2024-09-21T11:01:28Z","timestamp":1726916488000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2020-054718"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,4]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1,17]]},"published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1136\/sextrans-2020-054718"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2020-054718","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,4]]}}}