Anti-AIDS Pill, Vaginal Gel Unsuitable For Africa: Study

Jon Herskovitz, Reuters, March 4, 2013

Trying to prevent HIV infection through vaginal gels or daily tablets has proven ineffective in the southern African region ravaged by the disease because people did not use the medicines properly, a study released on Monday said.

A ground-breaking study issued in 2010 indicated a vaginal gel containing an HIV drug can sharply reduce infections in women who use it before and after sex.

However, a test of the gel and two types of anti-HIV pills among more than 5,000 women in South Africa, Zimbabwe and Uganda showed that, based on blood tests, more than 70 percent did not use the medication as instructed.

“We are obviously disappointed in the results. We were very hopeful that these products, which we know have been effective in other studies and clearly have a lot of promise, would work,” Jeanne Marrazzo, a researcher on the project for the University of Washington, told reporters in a teleconference.

“Women did not use consistently any of the products. Adherence was very low,” said Marrazzo, part of the project known as the Vaginal and Oral Interventions to Control the Epidemic (VOICE).

HIV/AIDS experts said the results showed how important a factor human behavior is when devising ways to prevent HIV.

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East and southern Africa are the areas most heavily affected by the HIV epidemic. Out of the total number of people worldwide in 2009 living with HIV, 34 percent were in 10 countries of southern Africa, according to the U.N. Programme on HIV/AIDS.

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The three-year study that started in September 2009 tested a daily tablet called Truvada, which was approved for HIV prevention in July 2012 by the U.S. Food and Drug Administration after it was shown to significantly reduce the risk of HIV infection when used as a preventative measure.

The gel with a drug called tenofovir, which a previous study showed reduced HIV infections in women by 39 percent over two and a half years, and an oral tenofovir tablet were also tested.

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“We need to rethink the design of these intervention trials . . . in healthy people because it is difficult for anybody to take a pill or anything every day, particularly when you are healthy and do not feel that you need a drug,” said Marrazzo.

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