Microbicides 2004 Microbicides 200428-31 March 2004, Hilton London MetropoleThe conference42 million men, women and children worldwide were living with HIV by the end of December 2002 (source: UNAIDS), including five million newly-infected during that year alone. Another 45 million people will become infected between 2002 and 2010, unless the current transmission rates can be vastly reduced. Of the 42 million, 29.4 million live in sub-Saharan Africa and 58% of them are women. Not only are women more susceptible to HIV infection, many are powerless to insist on the use of condoms or other methods of protecting themselves. In this context, and with the knowledge that an effective HIV vaccine is unlikely to be available for several years, the need for an effective topical microbicide grows ever more urgent. 2004 should prove to be a landmark year in the field of microbicide development as the first Phase III trials of novel products are due to start – the next step along the road to making a microbicide available to the millions worldwide in desperate need of protection.The aims of the Microbicides 2004 conference are to:Report novel or innovative work in the microbicides fieldProvide updates on recent microbicides research, divided into three tracks: basic science, clinical science, and behavioural science (including public health and the microbicide marketplace)Provide a forum for the discussion of new developments in microbicide research including ethical, clinical, behavioural and methodological issuesPresent opportunities for knowledge-sharing between microbicide researchers, public-health workers and advocacy organisations.There will be an opening ceremony on the evening of Sunday 28 March at which politicians, policy makers and the international media are expected. The conference will run for a full three days, each of which will contain:Scientific overviews and presentations with plenary sessions, invited lecturers and presentations of original researchWorkshops to review issues unique to microbicides such as trial design and outcome measures, and ethical issues in the clinical trials of microbicidesPoster sessions. Focus on LondonFollowing the successful Microbicides conferences in Washington in 2000 and Antwerp in 2002, March 2004 sees the focus move to London.The venue is the Hilton Metropole Hotel, two minutes by taxi from Paddington station and the Heathrow Express, with a journey time from the airport of 15 minutes. The hotel is in walking distance of Hyde Park and London’s main shopping streets, and close to Imperial College. Accommodation will be available at the venue and other hotels in the vicinity.London in March offers a variety of diversions for out-of-conference relaxation, including sight-seeing and shopping; the arts and the theatre; and pubs, clubs and restaurants to suit every taste. Conference staff will be on hand to help delegates plan their spare time.To book your place or find out more information, e-mail info@microbicides2004.org.uk or telephone the Event Office on +44 (0) 20 7720 4411
Oral: invited speaker Oral: Track A Oral: Track B Oral: Track C Poster: Track A Poster: Track B Poster: Track C Abstract only Authors

02614 VALIDITY AND FEASIBILITY OF SELF-SAMPLING FOR REPRODUCTIVE TRACT INFECTIONS IN SOUTH AFRICAN WOMEN

Altini, Lydia*
Jones H**, van de Wijgert J**, Young T*, De Kock A*, Hoosen A***, Coetzee N*
*University of Cape Town, South Africa; ** Population Council, New York, USA; ***Medical University of Southern Africa, South Africa

Objectives: To determine the validity of self-sampling (using tampons or vaginal swabs) for reproductive tract infections (RTIs) with swabs obtained during speculum examinations as the gold standard, and to evaluate feasibility and acceptability of self-sampling procedures. Validity and feasibility results are presented here.

Methods: Four hundred and fifty women from a Community Health Centre in Gugulethu, Cape Town were enrolled in a cross-sectional study: Half the women were randomized to use either tampons or vaginal swabs. All specimens were tested for bacterial vaginosis (BV) and yeasts (Gram stain), Trichomonas vaginalis (TV)(culture), Neisseria gonorrhoeae (NG)(PCR), Chlamydia trachomatis (CT)(PCR) and human papillomavirus (HPV)(Hybrid Capture II). Questionnaires and focus group discussions provided feasibility and acceptability data.

Results: Overall 62%, 28%, 11%, 7%, 11% and 45% of clinician obtained specimens were positive for BV, yeasts, TV, NG, CT and HPV respectively. The self-sampled specimens performed favorably against the gold standard with the exception of TV (sensitivity of self-sampling 40.4%, specificity 99.5%) and HPV (sensitivity 69.9%, specificity 87.4%). Vaginal swabs and tampons performed similarly for diagnosing BV, yeasts, NG and CT, but vaginal swabs were more sensitive than tampons for diagnosing HPV (p = 0.002) and possibly TV (p = 0.056). Both self-sampling methods were found to be feasible.

Conclusions: This study demonstrates that self-sampling methods are valid and feasible methods for the diagnosis of most RTIs; they could be used for data collection in microbicide trials. However when using culture to detect TV, self-sampling methods cannot be recommended. Tampons are a less sensitive method for the diagnosis of HPV in comparison to vaginal swabs when diluting the tampon specimen to detect multiple pathogens and using Hybrid Capture II technology.

Dr. Lydia Altini
Department of Public Health and Primary Health Care, University of Cape Town, Level 3 Falmouth building, Observatory 7925, Cape Town, South Africa
(Telephone) +27-21-406-6487 (Fax) +27-21-447-9088 (E-mail) laltini@cormack.uct.ac.za