The Abandoned Trials of Pre-Exposure Prophylaxis for HIV: What Went Wrong?

0824 New approaches to HIV/AIDS prevention are urgently needed to stem the estimated 5 million new infections that occur worldwide each year. One such promising, novel intervention has been the proposed use of the oral antiretroviral drug tenofovir (Viread) as a pre-exposure prophylaxis (PREP) in high-risk groups (for example, uninfected women who have high-risk commercial sex). However, emerging opposition has halted the progress of at least two important clinical trials of tenofovir as PREP and brought negative attention to tenofovir, somewhat similar to that visited on thalidomide more than four decades ago. This could prove damaging in the long term. If tenofovir is someday proven to be clinically effi cacious as a PREP, today’s irresponsible reporting and activism surrounding tenofovir could cause those in need to snub the drug if, or when, it becomes licensed for use as a PREP. This unfortunate prospect raises questions about responsible media reporting, responsible conduct on the part of investigators and activists, and what should be done to avert or repair damaging trial-related disputes in the future.