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Women's Low Adherence to Daily-Dose Products in HIV Prevention Trial Suggest Different Approach Needed, Researchers Say

March 5, 2013

"Results of a major HIV prevention trial suggest that daily use of a product -- whether a vaginal gel or an oral tablet -- does not appear to be the right approach for preventing HIV in young, unmarried African women," a press release from the Microbicide Trials Network reports (3/4). "Adherence among the women in the study was 'very low,' a researcher from the University of Washington said at the Conference on Retroviruses and Opportunistic Infections in Atlanta, where the results were presented," the New York Times writes. "The study, known as VOICE, for Vaginal and Oral Interventions to Control the Epidemic, followed more than 5,000 women in South Africa, Uganda and Zimbabwe" who were given tenofovir gel, oral tenofovir or oral Truvada, and found that, "[a]lthough 95 percent of the women in the study made their monthly clinic visits, and 70 percent said they were using the pills or gel, blood tests suggested that only 25 percent actually were," according to the newspaper (McNeil, 3/4).

"HIV/AIDS experts said the results showed how important a factor human behavior is when devising ways to prevent HIV," Reuters reports. "Clinicians and public health professionals will have to further assess and better understand how to promote and support the high levels of adherence necessary," Jonathan Mermin, an HIV/AIDS prevention expert at the CDC, said, the news agency notes (Herskovitz/Kelland, 3/4). "The VOICE study also found that single women under 25 were the least likely to use the product and the most likely to acquire HIV," a CONRAD press release states (3/4). Mitchell Warren, executive director of AVAC, "said one of the things African women are very concerned about is contraception," VOA News writes, adding, "Future research, therefore, could involve combining birth control pills with an antiretroviral drug" (DeCapua, 3/4). Writing in the Bill & Melinda Gates Foundation's "Impatient Optimists" blog, Stephen Becker, deputy director of the HIV program at the foundation, says the trial results "provide an opportunity to address fundamental factors that influence prevention product preferences and behaviors. To turn the tide we must stay committed to discovering and developing HIV prevention and treatment tools that those at risk will want and use" (3/4).

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