Daily Tenofovir-Containing PrEP Ineffective Among Women in Africa Due to Low Adherence

Daily oral pre-exposure prophylaxis (PrEP) and pericoital vaginal tenofovir gel have been shown to prevent HIV infection in some groups. The Vaginal and Oral Interventions to Control the Epidemic (VOICE) trial assessed whether daily treatment with oral tenofovir disoproxil fumarate (TDF), oral TDF/FTC, or vaginal 1% tenofovir gel could prevent new HIV infections among women in South Africa, Uganda, and Zimbabwe.

None of the regimens proved effective. HIV-infection incidence per 100 person-years — 5.7 overall (n=4947) — was 49% higher (P=0.07) in the TDF group, 4% higher (P=0.81) in the TDF/FTC group, and 15% lower (P=0.37) in the tenofovir gel group than in the placebo group. Although adherence was 90% by self-reports and 86% by returned-pro…