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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
AFRICA: HIV Trial Yields Disappointing Results
Joe DeCapua
March 5, 2013
Voice of America News (03.04.13)

A large-scale HIV prevention trial, called Vaginal and Oral Interventions to Control the Epidemic (VOICE), comprised of African women has produced disappointing results; however, the results may be based more on the behavior rather than the prevention methods utilized in the study. VOICE trial results were announced at the 20th Conference on Retroviruses and Opportunistic Infections in Atlanta. Executive Director Mitchell Warren of AVAC, a nonprofit HIV/AIDS advocacy group, stated that the study centered on PrEP— preexposure prophylaxis—and examined three different options to help African women prevent HIV infection. VOICE was funded by the US National Institutes of Health and was conducted with more than 5,000 women in Zimbabwe, South Africa, and Uganda. The women used the following prevention methods: a daily oral dose of tenofovir, a daily oral dose of a combination pill known as Truvada, and a daily 1-percent vaginal tenofovir gel. These methods previously had been shown to provide protection, but in the VOICE trial, the results were disappointing. Warren declared that “They were disappointing, and pivotal studies are not just ones that tell us the answers we want. A pivotal study is one to help give us answers to the questions we have. And this study showed that none of the three study products provided additional protection. They were safe, but not effective.” He said that the products will only succeed if they are used as prescribed. Warren noted that even though the women were dedicated to the trial and returned to the clinic every month, they did not actually use the products, further saying that behavior is more important than bio-medicine. Even though the daily pill and daily vaginal gel were convenient, the study participants did not respond. Warren declared one of the ideas the trial provided was that “while women may be at risk of HIV, they may not perceive themselves on a daily basis to be at risk.” Warren said that the African women in the study were concerned about contraception, so future research could involve using birth control pills with an antiretroviral drug. Warren stated that the VOICE study conveys to researchers the importance of listening to what women say and giving them something that they will use.

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