{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T18:27:37Z","timestamp":1771007257657,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2010,8,5]],"date-time":"2010-08-05T00:00:00Z","timestamp":1280966400000},"content-version":"vor","delay-in-days":216,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of the International AIDS Society"],"published-print":{"date-parts":[[2010,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Adherence problems with coitally dependent, female\u2010initiated HIV prevention methods have contributed to several trials' failure to establish efficacy. Continuous use of a cervical barrier with once\u2010daily cleaning and immediate reinsertion may simplify use for women and improve adherence. We assessed the acceptability and safety of precoital and continuous use of the Duet<jats:sup>\u00ae<\/jats:sup>, a cervical barrier and gel delivery system, in Zimbabwean women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using a two\u2010arm crossover design with a parallel observation group, we randomized 103 women in a <jats:bold>2:2:<\/jats:bold>1 ratio: (1) to use the Duet continuously for 14 days, followed by a minimum of seven days of washout and then 14 days of precoital use; (2) to use the same Duet regimens in reverse order; or (3) for observation only. Women were aged 18 to 40 years; half were recruited from a pool of previous diaphragm study participants and the other half from the general community. Acceptability and adherence were assessed through an interviewer\u2010administered questionnaire at each of two follow\u2010up visits. Safety was monitored through pelvic speculum exams and report of adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The proportion of women who reported consistent Duet use during sex was virtually identical during continuous and precoital regimens (88.6% vs. 88.9%). Partner refusal was the most common reason cited for non\u2010use during sex in both use regimens. Not having the device handy was the most common reason cited for non\u2010daily use (in the continuous regimen). Most women were \u201cvery comfortable\u201d using it continuously (86.3%) and inserting it precoitally (92.8%). The most favoured Duet attribute was that it did not interfere with \u201cnatural\u201d sex (55%). The least favoured Duet attribute was the concern that it <jats:italic>might<\/jats:italic> come out during sex (71.3%). No serious adverse events were reported during the study; 57 participants reported 90 adverse events classified as mild or moderate. There were no statistically significant differences in: (1) the proportion of women reporting adverse events; (2) the severity of events among those using the Duet and observational controls; or (3) event severity reported during each regimen use period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this study, the Duet was found to be acceptable and safe when inserted precoitally or used continuously for 14 days. Assignment to use of the Duet continuously did not increase adherence to the Duet during sex. Future HIV prevention trials should evaluate use of the Duet (precoitally and continuously) with promising microbicide candidates.<\/jats:p><\/jats:sec>","DOI":"10.1186\/1758-2652-13-30","type":"journal-article","created":{"date-parts":[[2010,8,6]],"date-time":"2010-08-06T06:13:54Z","timestamp":1281075234000},"page":"30-30","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["An acceptability and safety study of the Duet<sup>\u00ae<\/sup> cervical barrier and gel delivery system in Zimbabwe"],"prefix":"10.1002","volume":"13","author":[{"given":"Elizabeth T","family":"Montgomery","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia","family":"Woodsong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petina","family":"Musara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsungai","family":"Chipato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas R","family":"Moench","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Freya","family":"Spielberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariane","family":"van der Straten","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,8,5]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"UNAIDS: Report on the global AIDS epidemic: executive summary. 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