Promote use of drugs to prevent AIDS infection, researchers urge

lt on partnerships between sponsors, investigators, communities and governments," the authors wrote. "Cooperation among such diverse interests is never easy, and coalitions are easily fractured by acts of disrespect, misinformation or miscommunication.

"Such acts occurred too frequently in the early days of PrEP research, and hard lessons have been learned on all sides. While good faith efforts are made to improve the conduct of trials, a balance must be struck between the necessity to conduct trials to very high standards and the need to find ways to prevent the spread of HIV infection."

Concerns about PrEP trials first generated widespread publicity during the International AIDS Conference in Bangkok in 2004. Following protests there, preparations for a drug trial in Cambodia were suspended. In February this year, the government of Cameroon did the same.

The most promising PrEP drug to date is tenofovir disoproxl fumarate or TDF, which has an excellent safety record. Gilead, the company that developed it, has established a global access program that will allow it to be sold at cost in 95 countries. It also plans to set up a non-exclusive licensing agreement with a drug manufacturer in South Africa.

"I think PrEP may prove to be a safe and cost-effective way to prevent HIV," Grant said. "We cannot know until the research is completed."

Other authors are Dr. Susan Buchbinder of the University of California at San Francisco, Dr. Edith Clarke of the Ghana Health Service in Accra, Ghana, Dr. Thomas Coates of the University of California at Los Angeles, Martin Delaney of Project Inform in San Francisco, Guiselly Flores of Peru's Women Living with HIV/AIDS and Dr. Willard Cates Jr., Dr. Kathleen M. MacQueen and Dr. Leigh Peterson of Family Health International.

Others are Pedro Goicochea, Dr. Jorge Sanchez and Dr. Javier Lama of the Health and Education Association in Lima, Greg Gonsalves of Gay Men's Health Crisis in New Y

Contact: David Williamson
University of North Carolina at Chapel Hill

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