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The modest preventive efficacy seen in the RV144 vaccine trial in Thailand prompted an investigation of the recombinant canarypox vector (ALVAC-HIV) prime with a glycoprotein 120 (gp120) boost in South Africa (where HIV-1 subtype C prevails). ALVAC-HIV followed by four booster injections of bivalent subtype C gp120-MF59 was evaluated in the HVTN 702 phase 3 trial involving 5407 young adults (age range, 18–35; 70% women) randomized 1:1 to receive vaccine or placebo. At baseline, sexually transmitted infections were diagnosed in 30% of women and 18% of men. The primary outcome was HIV-1 infection within 24 months.
Incidence of HIV-1 infections did not differ between groups: 138 infections occurred in the vaccine group and 133 in the placebo gr…