Clinical trials evaluating oral Truvada for PrEP in women have had mixed results, with some (Partners PrEP and TDF2) showing efficacy among women in African countries and others (FEM-PrEP and VOICE) finding none due to lack of adherence, leading to confusion around whether daily oral PrEP is a viable HIV prevention tool for women.
What these PrEP trials have shown is that adherence -- taking PrEP daily as directed -- is both critical and complicated: PrEP works in people who take the pills as directed, but not everyone in every community and social environment will choose to (or be able to) take a daily pill. As Dr. Judith D. Auerbach of the University of California at San Francisco puts it, "the issue is really that certain women don't take pills, period."
To understand how women in the United States view daily oral PrEP and its relevance to their lives, Dr. Auerbach and fellow investigators with nonprofit policy and advocacy group AIDS United are conducting qualitative research -- that is, research that gathers data on opinions, attitudes, and knowledge about an intervention such as PrEP.
Dr. Auerbach sat down with BETA at the 21st Conference on Retroviruses and Opportunistic Infections to share updates on this research and offer her take on PrEP for U.S. women.
Given what you know from your own qualitative work and from clinical trials to date, what do you think is most important for people to understand about women and PrEP?
Dr. Auerbach: I think the most important thing for people to know is that PrEP probably works very well for women who actually take it.
iPrEx, the initial study of PrEP efficacy, was done primarily with gay men and a smaller number of transgender women, so PrEP very quickly became understood -- at least in the U.S. -- as a gay men's HIV prevention strategy, and a lot of straight women just never thought it was something they should be considering.
This excerpt was cross-posted with the permission of BETAblog.org.