Vaginal Tenofovir Gel May Lower the Risk for HSV-2 Acquisition

The VOICE trial was a multisite study of HIV-1 prevention among women in sub-Saharan Africa that compared tenofovir (TFV), tenofovir/emtricitabine, and tenofovir 1% vaginal gel. Primary trial results were negative, but participants' use of study product was low (NEJM JW Infect Dis Mar 2015 and N Engl J Med 2015; 372:509). In this secondary analysis of 1004 participants (566 [56%] HSV-2 seronegative) randomized to TFV gel, the investigators analyzed whether use of vaginal TFV gel affected the risk for HSV-2 infection.

During follow-up, 92 seroconverted to HSV-2 (incidence rate, 18.4 per 100 person-years). In an intent-to-treat analysis, HSV-2 incidence did not differ between women randomized to TFV gel versus placebo. However, when the analys…