Oral PrEP Is Effective for Women with Abnormal Vaginal Microbiota

Oral tenofovir-based pre-exposure prophylaxis (PrEP) has been shown to be highly effective for HIV prevention when patients are treatment adherent, albeit more so for men than women. Changes in the vaginal microbiota, specifically bacterial vaginosis (BV) with predominance of non-Lactobacillus spp, were recently postulated as a reason for lower protection among women in a trial of 1% tenofovir gel (NEJM JW Infect Dis Jul 2017 and Science 2017; 356:938).

Now, investigators have conducted a post-hoc analysis of the Partners PrEP Study (AIDS 2013; 27:2155) of heterosexual HIV-1 serodiscordant couples from Kenya and Uganda to determine if the presence of bacterial vaginosis affects the efficacy of oral PrEP. Vaginal swabs obtained from women at …