Supporting consistent use of HIV prevention methods: Lessons from clinical trials
Recent clinical trials have highlighted the importance of adherence to antiretroviral (ARV) drug regimens for the prevention of HIV infection. Investigators from the Preventive Technologies Agreement and the Microbicide Trials Network group within FHI 360 are co-authors of two new articles offering lessons on adherence to ARV-based products for HIV prevention.
Several clinical trials have shown that a daily dose of one of the antiretroviral (ARV) drugs used to treat HIV can also help prevent HIV in individuals at high risk of infection. Another trial (CAPRISA 004) found that use of an ARV-based vaginal gel — before and after sex — reduced women’s risk of acquiring HIV; the Follow-on African Consortium for Tenofovir Studies (FACTS) is conducting a confirmatory trial.
But trials have also highlighted the importance of adherence to these ARV-based regimens, which work only when used consistently. Two new articles offer lessons on adherence from trials of ARV-based HIV prevention methods:
Adherence support approaches in biomedical HIV prevention trials: Experiences, insights and future directions from four multisite prevention trials. K. Rivet Amico, Center for Health Interventions and Prevention, University of Connecticut, Storrs, CT, USA; Leila E. Mansour, Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa; Amy Corneli and Kristine Torjesen, FHI 360, Durham, NC, USA; Ariane van der Straten, Women’s Global Health Imperative, RTI International (Research Triangle Institute) and Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA.
Published in the journal AIDS and Behavior, this article describes the adherence support programs of four pivotal trials of ARV-based prevention: CAPRISA 004, FEM-PrEP, iPrEx and VOICE.
Microbicide clinical trial adherence: Insights for introduction. Cynthia Woodsong, International Partnership for Microbicides, Silver Spring, MD, USA; Kathleen MacQueen, FHI 360, Durham, NC, USA; K. Rivet Amico, Center for Health Interventions and Prevention, University of Connecticut, Storrs, CT, USA; Barbara Friedland, Population Council, New York, NY, USA; Mitzy Gafos, MRC Clinical Trials Unit, London, UK; Leila E. Mansour, Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa; Elizabeth Tolley, FHI 360, Durham, NC, USA; Sheena McCormack, MRC Clinical Trials Unit, London, UK.
This article in the Journal of the International AIDS Society provides recommendations for using the lessons about adherence from trials of microbicide gels to prepare for future trials, post-marketing research and the introduction and delivery of microbicide products as an HIV prevention strategy.
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