Why an HIV prevention trial failed in Africa

Posted in HIV Cover, HIV Virus | 0 comments

handsA test done on 5000 woman in Zimbabwe, Uganda and in South Africa showed that the daily regimens done to prevent and stop the HIV  disease are not working.  The reason for this is that most of the woman involved in this test were not taking the medicine that they were given.  The results show just how the HIV stigma and the fear of HIV can waylay disease prevention tests and trials and reinforces the need for more effective dosage methods like a weekly pill or similar.

The trial was called VOICE, and stands for Vaginal and Oral Interventions to Control the Epidemic.  The trials to test the HIV prevention strategies lasted from September 2009 up till August 2012.  It was supposed to have lasted longer but due to futility it had to be stopped earlier.  There were no positive results in the trial and even though the same tools were used elsewhere and worked, it did not work in these areas.

One way to prevent the spreading of the HIV virus in high risk settings is called Pre-exposure prophylaxis (PrEP).  It was done in the US with a drug called Gilead Sciences’ Truvada, which must be taken by a High Risk Patient on a daily basis.  The Voice looked at 2 drugs, one being Truvada and the other Gilead Sciences drug called Viread.  The researchers also used a virginal gel formulation which contained a compound present in Viread.  These drugs were not working even though the drugs usefulness was never in question.

We all know that medications that are not taken will not work.  To determine if the woman were taking their medications blood tests were done.  After 3 months it was proven that the woman were not taking there preventative medicine at all.  This was concluded by a study done by the New England Journal of Medicine.  It was also concluded that the woman who never took their medications were woman under the age of 25, and they are in the category of the ones who were more at risk.  At some of the trial sites as many as 10 out of 100 of these women were infected yearly.

When medication are not taken it will not work, and that is the reason why there was no difference in efficacy of the medication drugs active-drug and placebo groups.  The drugs do work when taken, but they weren’t taken by these woman.

When doing some inquiries it was found that the reason they did not take their medication was as a result of many not knowing if the drug was really effective because these drugs were associated with the HIV infection rather than the prevention thereof, and secondly there was a lack in social support.  Even though the drugs worked, the human factor did not.

This study indicated that a great deal of work is still needed to be done on the realm of behavioural barriers rather than on the realm of understanding the biological basis of the pre-exposure prophylaxis as a preventative treatment.

The area with the worst cases of the HIV epidemic is in the Sub-Saharan Africa, where it has been  estimated that 25 million people are infected there.  Of the 25 million infected, 60% of them are female.  The main cause of the infection in Sub-Saharan Africa is of a sexual nature.  They cannot insist on the use of condoms even though it would help to protect them against contracting the HIV virus.

Most of these woman claimed that they had been taking the medication, even though the blood tests showed differently.  In the 3 months time, fewer than 40 % of the samples taken showed no level of the assigned study drugs in their blood.  Later on most of these woman did not have positive results either.  88 to 90% of these woman claimed they had take the treatment drugs, but the blood results proved to say otherwise.  They went as far as bringing their medication back to be counted on the reconciliation days so that the researchers could count the unused pills.  After having counted the used pills, it showed that 86 percent of the medication had been taken, and once again was not true, because the blood tests said different.

This showed that many of the participants had removed the unused medications from the holders that the pills were in in order to fool the researchers into believing that they had taken the medication.  This leaves the question of why they had to go to such lengths to hide the fact that they were not taking the medication.

One of the participants came forward and said that they had lied because they had been afraid.   They had heard some rumours that the drugs could cause liver damage and even harm their reproductive organs. To make the matter worse is that fact that the woman were paid $10-$15 each time they visited the clinic, which was a valuable income to them, and even the would be participants who did not intend to participate profited from this.

These results don’t mean much in the HIV treatments, they have however changed the way that the studies will be conducted in future.  The blood tests will now be done beforehand and not left for a later date.

Leave a Reply

Your email address will not be published. Required fields are marked *