title: Comparison of sampling methods to measure HIV RNA viral load in female genital tract secretions.
abstract: How does menstrual cup (MC) compare to other genital sampling methods for HIV RNA recovery?
  
  
  
  We compared HIV RNA levels between MC, endocervical swab (ECS), and ECS-enriched cervicovaginal lavage (eCVL) specimens in 51 HIV-positive, antiretroviral therapy-naive women at enrollment, 3 and 6 months, with order rotated by visit. Paired comparisons were analyzed with McNemar's exact tests, signed-rank tests, and an extension of Somer's D for pooled analyses across visits.
  
  
  
  MC specimens had the highest proportion of quantifiable HIV VL at enrollment and month 3, but more MC specimens (n=12.8%) were insufficient for testing, compared with ECS (2%, P=0.006) and eCVL (0%, P<0.001). Among sufficient specimens, median VL was significantly higher for MC (2.62 log10copies/mL) compared to ECS (1.30 log10copies/mL, P<0.001) and eCVL (1.60 log10copies/mL, P<0.001) across visits.
  
  
  
  MC may be more sensitive than eCVL and CVS, provided insufficient specimens are reduced.
authors.affiliation: Division of Medical Virology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.
authors.forename: Shameem Z
authors.initials: SZ
authors.lastname: Jaumdally
authors.affiliation: Department of Epidemiology and Biostatistics, City University of New York Graduate School of Public Health & Health Policy, New York, NY, USA.
authors.forename: Heidi E
authors.initials: HE
authors.lastname: Jones
authors.affiliation: Department of Statistics & Biostatistics, Rutgers The State University, Piscataway, NJ, USA.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Hoover
authors.affiliation: Division of Medical Virology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.
authors.forename: Hoyam
authors.initials: H
authors.lastname: Gamieldien
authors.affiliation: Division of Medical Virology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.
authors.forename: Jean-Mari
authors.initials: JM
authors.lastname: Kriek
authors.affiliation: Division of Epidemiology & Biostatistics and Centre for Infectious Diseases Epidemiology & Research School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Nontokozo
authors.initials: N
authors.lastname: Langwenya
authors.affiliation: Division of Epidemiology & Biostatistics and Centre for Infectious Diseases Epidemiology & Research School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Landon
authors.initials: L
authors.lastname: Myer
authors.affiliation: Division of Medical Virology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.|National Health Laboratory Services, Cape Town, South Africa.
authors.forename: Jo-Ann S
authors.initials: JS
authors.lastname: Passmore
authors.affiliation: FHI 360, Durham, NC, USA.
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Todd
mesh_terms: D000293:Adolescent; D000328:Adult; D004311:Double-Blind Method; D005260:Female; D053566:Hygiene Products; D005836:Genitalia, Female / Q000821:virology*; D015658:HIV Infections / Q000175:diagnosis*; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D007434:Intrauterine Devices / Q000706:statistics & numerical data*; D008598:Menstruation; D012367:RNA, Viral / Q000032:analysis*; D013048:Specimen Handling / Q000379:methods*; D019562:Viral Load; D055815:Young Adult
chemical_list: D053566:Hygiene Products; D012367:RNA, Viral
keywords: cervicovaginal lavage; endocervical swab; female genital tract sampling; genital HIV viral load; menstrual cup