CROI 2013A large trial of three different pre-exposure prophylaxis (PrEP) methods has failed to protect a large cohort of African women against HIV transmission, The New York Times reports. The disappointing results from the VOICE (Vaginal and Oral Interventions to Control the Epidemic) trial were announced at the 20th Conference on Retroviruses and Opportunistic Infections (CROI) in Atlanta.

The three PrEP methods tested in the trial included daily oral Viread (tenofovir), daily oral Truvada (emtricitabine/tenofovir) and a daily vaginal gel of 1 percent tenofovir. A lack of adherence, and not the methods themselves, was to blame for the trial’s failure. These findings are in line with the results of previous studies that have outlined a strong correlation between adherence to PrEP and its potency as an HIV prevention tool.

The study’s results are a setback in the race to find effective PrEP methods to empower women worldwide to protect themselves against HIV infection. But the AIDS Vaccine Advocacy Coalition (AVAC) stresses that the results do not invalidate the findings of previous studies showing that oral tenofovir-based PrEP was highly effective for women in stable relationships with an HIV-positive partner and that vaginal tenofovir was modestly effective, although at a different dosing schedule. AVAC calls for a renewed focus and intensified research into PrEP strategies that are not so dependent on adherence and which women may find more appealing and easier to use.

“Biomedical tools do not work in a vacuum but rather in the complex realities of women’s and girls’ lives,” Mitchell Warren, AVAC executive director, said in a statement. “The women of VOICE and other prevention trials have much to tell us. Now we need to listen to what they are saying and design prevention options based on a better understanding of their reproductive and sexual health needs and desires, their perceptions of personal risk for HIV infection, and their interest in and ability to use the products offered in those trials.”

To read the New York Times story, click here.

To read the AVAC release, click here. 

Editor's Note: This article has been updated.