Blinded by Bigotry: Why Researchers May Have Been the Only Ones Surprised by VOICE Trial Failure

7 Feb

Bloodborne HIV: Don't Get Stuck!

The failure of the VOICE pre-exposure prophylaxis trial, daily treatment of HIV negative people with antiretroviral drugs via a vaginal ring, was guaranteed by the long and widely held assumption that almost all HIV transmission in African countries is a result of ‘unsafe’ sexual behavior.

Participants were deemed to be at risk of being infected with HIV by researchers who had no evidence for this risk. In fact, sexual risk was low, with only one fifth reporting more than one sex partner in the previous three months, relatively low rates of sexual intercourse, very high rates of condom use and fairly low rates of anal sex (which may or may not have involved condoms).

During this trial HIV incidence was very high, more than 6 cases per 100 person years. Yet, researchers made no effort to find out how the several hundred seroconverting women were infected. There were high rates…

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