Using ARVs for prevention

Robin Shattock, who leads a research team at the Centre for infection and Immunity at St George’€™s University in London, said that numerous prevention studies were investigating the effectiveness of tenofovir as a prevention method.

Shattock said the battle against HIV would not be won by treatment alone but there was a need for more effective prevention methods.

Trials currently underway include CAPRISA 004, a collaborative study between Family Health International, the Centre for the AIDS Programme of Research in South Africa (CAPRISA) at the University of KwaZulu-Natal, and US-based CONRAD. The study is taking place in Durban and is assessing the effectiveness of a gel containing tenofovir, a widely used ARV.

The results of the study will be presented at the International AIDS conference in Vienna, Austria in July this year.

Another study was the Vaginal and Oral Intervention to Control the Epidemic (VOICE) which started last year and is also testing the effectiveness of tenofovir in a vaginal gel compared to a tenofovir tablet taken orally.

The VOICE study will also inform the CAPRISA 004 study as to whether women prefer a tablet or a gel.

Nomfundo Eland from the Treatment Action Campaign said there was a need for improved delivery systems alongside scientific research.

‘€œResearch and science alone will not win the fight on new infection but we will win when combined strategies to address behaviour, gender inequality, economic status of women and access to prevention tools owned by women are available,’€ Eland told the conference.

She said it was critical to engage communities and to get communities informed on the various prevention methods and trials taking place within their vicinity.

‘€œWe need to know who our allies in this work are. For example, I was recently addressing one of the biggest and most influential workers’€™ unions in SA – where no-one knew of any prevention trials happening in the country until the world makes noise about ‘€œfailed trials’€ in their backyard,’€ she said.

She said issues such as stigma, policies that discriminate against those infected with HIV, sexual discrimination and funding cuts continued to pose a threat in the success of prevention methods.

Vuyiseka Dubula, General Secretary, Treatment Action Campaign urged researchers to persevere amidst the challenges.

‘€œI know that there is a lot of negativity on prevention biomedical research due to many microbicides studies being disappointing but we cannot give up. Activism without science is nothing and science without activism can only go so far. We need evidence to advocate for better tools for prevention,’€ she said.

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