Prevention: New Approach Will Test Tenofovir for Persons at High Risk

In a new approach to HIV prevention, the Bill & Melinda Gates Foundation will fund a multi-national trial of the antiretroviral drug tenofovir, taken orally once daily by HIV negative persons at high risk, to see if it can prevent HIV infection. The study, by Family Health International, will take three years, and will focus on sexually active adults in countries with high HIV incidence. If it works, this method could be particularly important for women who cannot negotiate condom use or other ways of protecting themselves.

Dr. Helene Gayle of the Bill & Melinda Gates Foundation noted that experience in using antiretrovirals to protect healthcare workers exposed to HIV, and infants exposed during childbirth, offered hope that it might be possible to prevent sexual transmission as well.


Comment
This study is important because it could open a new front in HIV prevention -- and provide a woman-controlled protection method before microbicides or vaccines are available. Animal studies have suggested that the drug may prevent infection. And tenofovir, approved for over a year in the U.S. for use in HIV treatment, has fewer side effects than other antiretrovirals, so it may be acceptable to persons at high risk but not already infected.