Pre-exposure prophylaxis for HIV
Evidence
In the CAPRISA 004 study in South Africa, 889 high-risk women used 1% tenofovirgel vaginally up to 12 h before intercourse and within 12 h after intercourse.[81] This study reported a 39% reduction in HIV acquisition overall, and maximal reduction of 54% in women who were the most adherent. HIV acquisition was inversely correlated with detection of tenofovirin the vaginal secretions, an indication of the strong association between product adherence and efficacy. In the iPrEx study completed in 2010, HIV-negative MSM were provided daily emtricitabine and tenofivirdisoproxilfumarate (TDF + FTC) for up to 2.8 years. The study found 44% reduction in HIV acquisition, and as with the CAPRISA trial, efficacy was strongly associated with ARV drug concentrations. Another study, conducted by CDC in partnership with Botswana Ministry of Health, found that a once-daily tablet containing TDF+FTC reduced the risk of acquiring HIV infection by roughly 63% overall in the study population of uninfected heterosexual men and women.