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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Efficacy of preexposure prophylaxis for HIV-1 prevention among high-risk heterosexuals: Subgroup analyses from a randomized trial
AIDS, Volume 27, No. 13, Year 2013
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Description
Background: Daily oral antiretroviral preexposure prophylaxis (PrEP) is a promising strategy for prevention of HIV-1 acquisition. Three clinical trials demonstrated PrEP efficacy; however, two PrEP trials among women did not find protection against HIV-1. One hypothesis proposed for these divergent results is that PrEP efficacy may be reduced in populations with higher HIV-1 incidence. Methods: Using data from the Partners PrEP Study, a randomized, placebo-controlled trial of daily oral tenofovir (TDF) and emtricitabine/ tenofovir (FTC/TDF) PrEP among heterosexual HIV-1 serodiscordant couples from Kenya and Uganda, we assessed PrEP efficacy among subgroups at higher risk for HIV-1 acquisition, including subgroups of women with high HIV-1 incidence. Results: The overall placebo arm HIV-1 incidence was 2.0 per 100 person-years. Among higher risk subgroups, placebo arm HIV-1 incidence ranged from 3.9 to 6.6 per 100 person-years. In all subgroups, PrEP was protective against HIV-1 acquisition, with efficacy point estimates ranging from 64 to 84%. Among subgroups of women with placebo-arm HIV-1 incidence more than 5.0, efficacy estimates ranged from 64 to 84%. Monthly visit attendance for PrEP refills and tenofovir detection in plasma were high. Conclusion: Among higher-risk subgroups in the Partners PrEP Study, including groups solely of higher-risk women, both TDF alone and combined FTC/TDF PrEP had consistently high efficacy for HIV-1 protection. PrEP, when used with high adherence, is a highly effective prevention strategy for higher risk heterosexuals. Prioritizing PrEP for persons at high risk of HIV-1 will maximize its prevention impact. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Authors & Co-Authors
Murnane, Pamela M.
United States, Seattle
University of Washington
Celum, Connie L.
United States, Seattle
University of Washington
Mugo, Nelly Rwamba
United States, Seattle
University of Washington
Kenya, Nairobi
University of Nairobi
Kenya, Nairobi
Kenyatta National Hospital
Campbell, James D.
Uganda
National Center for Hiv
United States, Baltimore
University of Maryland School of Medicine
Donnell, Deborah J.
United States, Seattle
University of Washington
United States, Seattle
Fred Hutchinson Cancer Research Center
Bukusi, Elizabeth Anne
United States, Seattle
University of Washington
Kenya, Nairobi
University of Nairobi
Kenya, Nairobi
Kenyatta National Hospital
Mujugira, Andrew
United States, Seattle
University of Washington
Tappero, Jordan W.
United States, Atlanta
Centers for Disease Control and Prevention
Kahle, Erin M.
United States, Seattle
University of Washington
Thomas, Katherine K.
United States, Seattle
University of Washington
Baeten, Jared M.
United States, Seattle
University of Washington
Statistics
Citations: 126
Authors: 11
Affiliations: 7
Identifiers
Doi:
10.1097/QAD.0b013e3283629037
e-ISSN:
14735571
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Study Locations
Kenya
Uganda
Participants Gender
Female