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Nel A, van Niekerk N, Kapiga S, Bekker LG, Gama C, Gill K, Kamali A, Kotze P, Louw C, Mabude Z, Miti N, Kusemererwa S, Tempelman H, Carstens H, Devlin B, Isaacs M, Malherbe M, Mans W, Nuttall J, Russell M, Ntshele S, Smit M, Solai L, Spence P, Steytler J, Windle K, Borremans M, Resseler S, Van Roey J, Parys W, Vangeneugden T, Van Baelen B, Rosenberg Z. Safety and Efficacy of a Dapivirine Vaginal Ring for HIV Prevention in Women. N Engl J Med 2016; 375:2133-2143. [PMID: 27959766 DOI: 10.1056/nejmoa1602046] [Citation(s) in RCA: 346] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The incidence of human immunodeficiency virus (HIV) infection remains high among women in sub-Saharan Africa. We evaluated the safety and efficacy of extended use of a vaginal ring containing dapivirine for the prevention of HIV infection in 1959 healthy, sexually active women, 18 to 45 years of age, from seven communities in South Africa and Uganda. METHODS In this randomized, double-blind, placebo-controlled, phase 3 trial, we randomly assigned participants in a 2:1 ratio to receive vaginal rings containing either 25 mg of dapivirine or placebo. Participants inserted the rings themselves every 4 weeks for up to 24 months. The primary efficacy end point was the rate of HIV type 1 (HIV-1) seroconversion. RESULTS A total of 77 participants in the dapivirine group underwent HIV-1 seroconversion during 1888 person-years of follow-up (4.1 seroconversions per 100 person-years), as compared with 56 in the placebo group who underwent HIV-1 seroconversion during 917 person-years of follow-up (6.1 seroconversions per 100 person-years). The incidence of HIV-1 infection was 31% lower in the dapivirine group than in the placebo group (hazard ratio, 0.69; 95% confidence interval [CI], 0.49 to 0.99; P=0.04). There was no significant difference in efficacy of the dapivirine ring among women older than 21 years of age (hazard ratio for infection, 0.63; 95% CI, 0.41 to 0.97) and those 21 years of age or younger (hazard ratio, 0.85; 95% CI, 0.45 to 1.60; P=0.43 for treatment-by-age interaction). Among participants with HIV-1 infection, nonnucleoside reverse-transcriptase inhibitor resistance mutations were detected in 14 of 77 participants in the dapivirine group (18.2%) and in 9 of 56 (16.1%) in the placebo group. Serious adverse events occurred more often in the dapivirine group (in 38 participants [2.9%]) than in the placebo group (in 6 [0.9%]). However, no clear pattern was identified. CONCLUSIONS Among women in sub-Saharan Africa, the dapivirine ring was not associated with any safety concerns and was associated with a rate of acquisition of HIV-1 infection that was lower than the rate with placebo. (Funded by the International Partnership for Microbicides; ClinicalTrials.gov number, NCT01539226 .).
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Affiliation(s)
- Annalene Nel
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Neliëtte van Niekerk
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Saidi Kapiga
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Linda-Gail Bekker
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Cynthia Gama
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Katherine Gill
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Anatoli Kamali
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Philip Kotze
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Cheryl Louw
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Zonke Mabude
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Nokuthula Miti
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Sylvia Kusemererwa
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Hugo Tempelman
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Hannelie Carstens
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Brid Devlin
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Michelle Isaacs
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Mariëtte Malherbe
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Winel Mans
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Jeremy Nuttall
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Marisa Russell
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Smangaliso Ntshele
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Marlie Smit
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Leonard Solai
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Patrick Spence
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - John Steytler
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Kathleen Windle
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Maarten Borremans
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Sophie Resseler
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Jens Van Roey
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Wim Parys
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Tony Vangeneugden
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Ben Van Baelen
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
| | - Zeda Rosenberg
- From International Partnership for Microbicides, Silver Spring, MD (A.N., N.N., H.C., B.D., M.I., M.M., W.M., J.N., M.R., S.N., M.S., L.S., P.S., J.S., K.W., Z.R.); London School of Hygiene and Tropical Medicine, London (S. Kapiga); Mwanza Intervention Trials Unit, Mwanza, Tanzania (S. Kapiga); Desmond Tutu HIV Centre, University of Cape Town, Cape Town (L.-G.B., K.G.), Maternal, Adolescent, and Child Health Research, Edendale (C.G., Z.M.), Qhakaza Mbokodo Research Clinic, Ladysmith (P.K.), Prevention for HIV and AIDS Project, Pinetown (N.M.), Madibeng Centre for Research, Brits, the Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria (C.L.), and Ndlovu Care Group, Elandsdoorn (H.T.) - all in South Africa; Medical Research Council-Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda (A.K., S. Kusemererwa); and SGS Life Science Services-Biometrics, Mechelen (M.B., S.R.), and Janssen Research and Development, Beerse (J.V.R., W.P., T.V., B.V.B.) - both in Belgium
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