There was disappointing news last week on HIV prevention. The VOICE study looking at HIV prevention in women discontinued the use of tenofovir pills (brand name Viread). However, a combination of tenofovir with another HIV medication, emtricitabine (together under the brand name Truvada), will continue to be studied, as well as a tenofovir gel used vaginally.
According to the National Institute of Allergy and Infectious Disease (NIAID), an interim review showed that “the study will be unable to show a difference in effect between tenofovir tablets and placebo [inactive] tablets.”
VOICE (Vaginal and Oral Interventions to Control the Epidemic) is looking at the concept of PrEP (pre-exposure prophylaxis, or prevention), the use of HIV medications in uninfected people to see if they work for prevention as well as treatment. Successes with PrEP have dominated HIV conferences over the past year and a half. First tenofovir gel used vaginally was shown to reduce infections in women by 42% in the CAPRISA 004 study. Then the iPrEx study showed an HIV reduction of 42% to 93% in men and transgender women with the use of a daily Truvada tablet. Later, the Partners study showed a reduction in HIV with either Viread or Truvada pills in serodiscordant couples (where one partner is positive and the other is uninfected), and the TDF2 study showed a 63% reduction in acquiring HIV with Truvada pills in men and women.
Begun in September 2009, the VOICE study, or MTN-003, involves more than 5,000 HIV-uninfected women in South Africa, Uganda, and Zimbabwe. The 1,000 women given tenofovir tablets will stop participating in the study and will be given information on where to continue receiving HIV testing and counseling as well as other medical and support services.
From Positively Aware, reprinted with permission.