New African HIV Drug Trial Fails

A large HIV drug trial in Africa has failed because women don’t consistently use the medicines, according to a presentation at yesterday’s Conference on Retroviruses and Opportunistic Infections. Donald G. McNeil Jr. for The New York Times said that over 5,000 women in South Africa, Zimbabwe, and Uganda were given either pills or a vaginal gel containing a proven antiretroviral drug known to provide some protection against the spread of the virus.

However, the women were just as likely to get HIV as women who didn’t get the drugs, and the rates of HIV exposure in young women under 25 in South Africa were truly frightening. McNeil noted:

“Although 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.”

The Microbicide Trials Network that conducted the study for VOICE — Vaginal and Oral Interventions to Control the Epidemic — did not mince words in their press release in which they quoted Dr. Jeanne Marrazzo, one of the researchers who conducted the field trials in Africa:

“”Although there may be other explanations for why these products don’t always work to prevent HIV, it’s hard to ignore the fact that so few women in our study used them. Clearly, an approach of daily product use is not going to work for the population of women who participated in VOICE. Equally important, the women in our study—especially in South Africa—experienced rates of HIV acquisition that were much higher than we expected.”

The problem of slowing the spread of HIV in Africa has been a challenging one. In some rural areas, it’s difficult for women to get hold of a regular supply of a product they must use every day. Some women may also not be educated enough to fully understand that they need to use the protection regularly, not just once in awhile.

The Inquistr’s James Johnson previously reported on a study that showed that women who used injectable hormones for birth control — a method that requires only an occasional visit to the doctor — may actually have up to twice the rates of HIV because that method doesn’t provide any protection against the spread of the virus.

This weekend, researchers stunned the world with a report from Mississippi who became the first known child to be cured of the HIV virus. However, an after-the-fact cure is still very rare. Prevention is really the key for almost everyone, whether in the US or Africa.

“No intervention is going to be effective if it’s not used,” said Dr. Marrazzo. The HIV drug trials in Africa were particularly disappointing because the highest-risk patients, young unmarried women under age 25, were even less likely to use the drugs than other women.