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Safety of multiple daily applications of COL-1492, a nonoxynol-9 vaginal gel, among female sex workers

Van Damme, Luta; Chandeying, Verapolb; Ramjee, Gitac; Rees, Helend; Sirivongrangson, Pacharae; Laga, Mariea; Perriëns, Josf; on behalf of COL-1492 Phase II Study Group

Epidemiology and Social: Concise Communication

Rationale: COL-1492 is a nonoxynol-9 (N-9)-containing vaginal gel and may be a potential microbicide. As part of an effectiveness trial, an initial toxicity study was conducted.

Objectives: The main objective of the reported study was the assessment of the toxicity of a 52.5 mg N-9 gel, COL-1492, when used a number of times each day by female sex workers.

Methods: This was a randomized, placebo-controlled triple-blinded trial among female sex workers. The participants were asked to use the product for each vaginal sexual act. At each monthly visit a gynaecological examination with sexually transmitted disease sampling and colposcopy was performed. Venous blood was drawn for syphilis and HIV serology. All women received intensive counselling on condom use. Male condoms and sexually transmitted disease treatment were given free of charge.

Results: Only blinded results on the colposcopic examinations are reported. The incidence of lesions with or without an epithelial disruption was low: 0.06 and 0.29, respectively, per 100 woman–days in group A; 0.09 and 0.26 respectively per 100 woman–days in group B. There was no significant difference between the two arms.

Conclusion: The multiple daily use of COL-1492 by female sex workers did not show an increase of local toxicity over that of a placebo. Colposcopy was discontinued in the autumn of 1997 in accordance with a Data Safety Monitoring Board decision. In the currently ongoing effectiveness trial the assessment of the product's toxicity continues to be monitored by simple visual examination.

From the aInstitute of Tropical Medicine, Antwerp, Belgium, the bPrince of Songkla University, Hat Yai, Thailand, the cCentre for Epidemiological Research (CERSA), Durban, the dReproductive Health Research Unit, Johannesburg, Republic of South Africa, eMinistry of Public Health, VD Division, Bangkok, Thailand and fUNAIDS, Geneva, Switzerland. *See Appendix.

Correspondence to Lut Van Damme, STD/HIV Research and Intervention Unit, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium.

Received: 8 October 1999; revised: 23 September 1999; accepted: 27 October 1999.

© 2000 Lippincott Williams & Wilkins, Inc.