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A public cervix announcement: CERVICAL BARRIERS in seven minutes. Katy R. Backes Ibis Reproductive Health March 28, 2004 Microbicides Advocates Meeting. Cervical barriers (CBs). What are CBs?

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a public cervix announcement cervical barriers in seven minutes

A public cervix announcement: CERVICAL BARRIERS in seven minutes

Katy R. Backes

Ibis Reproductive Health

March 28, 2004

Microbicides Advocates Meeting

cervical barriers cbs
Cervical barriers (CBs)
  • What are CBs?
    • Cervical barriers (diaphragms and cervical caps) are latex or silicone cups that fit at the upper end of the vaginal tract, covering the cervix.
  • CBs have a long history as contraceptives. When used with spermicide, they are
  • 60-94% effective against pregnancy.
cbs and hiv sti prevention
CBs and HIV/STI prevention
  • The cervix is fragile
    • Entrance lined with delicate cells
    • This layer is only 1 cell thick
  • Preferential site of infection for many STI
    • Bacterial pathogens (gonorrhea, chlamydia)
    • Human papilloma virus
  • Concentration of HIV receptor sites
  • Protection of the upper genital tract
  • Limitations - No protection for the vulva, urethra, and vagina

Moench T, Chipato T, Padian N. 2001. Preventing disease by protecting the cervix:  the unexplored promise of internal vaginal barrier devices.  AIDS, 15(13):1595-1602.

mira trial
MIRA Trial
  • What is it? A randomized, controlled trial to measure the effectiveness of the diaphragm used with lubricant gel in preventing HIV infection

among women

  • How does it work?
    • All participants receive condoms, safe

sex counseling, and STI treatment

    • Half also receive a diaphragm and gel and counseling on use
    • We will compare outcomes between these groups
  • Where is it happening? South Africa and Zimbabwe
  • When will we know the results? By 2007
research on diaphragm acceptability
Research on diaphragm acceptability
  • United States

Harvey SM et al. Who continues using the diaphragm and who doesn’t: implications for the acceptability of female-controlled HIV prevention methods. Women’s Health Matters. 2003; 13:185-93.

  • Developing Countries
    • Colombia, Turkey, Philippines

Bulut A et al. Assessing the acceptability, service delivery requirements, and use-effectiveness of the diaphragm in Colombia, Philippines, and Turkey. Contraception. 2001 May;63(5):267-75.

    • Brazil

do Lago TD et al. Acceptability of the Diaphragm Among Low-Income Women in Sao Paulo, Brazil. International Family Planning Perspectives. 1995 Sep:21(3):114-118.

    • India

Ravindran TKS and Rao SS, Is the diaphragm a suitable method of contraception for low-income women: a user perspectives study, Madras India.

    • Zimbabwe (UZ-UCSF)
products
Products
  • Diaphragms
    • All-Flex, Coil Spring,

Semina, Wide Seal

  • Cervical caps
    • Prentif, Oves, FemCap,

(Vimule, Dumas)

  • Other cervical barriers
    • Lea’s Shield
  • Female condom – protects against HIV/STI
  • Sponges
  • Products under development
    • (SILCS, BufferGel cup)
slide7
**CBAS**
  • The Cervical Barrier Advancement Society (CBAS) aims to raise the profile of cervical barriers both for preventing pregnancy and potentially HIV and other STIs
  • Coming soon:

www.cervicalbarriers.org