News & AnalysisAIDS Research

Complexity Surrounds HIV Prevention Advances

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Science  22 Jul 2011:
Vol. 333, Issue 6041, pp. 393
DOI: 10.1126/science.333.6041.393

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Two trials have showed, for the first time, that giving relatively safe and inexpensive antiretroviral (ARV) pills each day to uninfected people dramatically reduced the risk of heterosexual transmission of HIV. During the past year, this pre-exposure prophylaxis (PrEP) strategy has proved effective in men who have sex with men, but similar studies in heterosexual women had mixed results: An ARV-containing vaginal gel worked, but ARV pills did not. Most of the 34 million infections in the world occur via the heterosexual route, so progress in this area could be a game-changer. Before PrEP can be widely used, however, the field must wrestle with myriad practical, ethical, and financial issues.