Three antiretroviral products evaluated among African women in the Vaginal and Oral Interventions to Control the Epidemic (VOICE) HIV prevention trial were found to be safe but, because of poor adherence, were not effective in preventing sexually acquired HIV (Marrazzo JM et al. N Engl J Med. 2015;372[6]:509-518).
The VOICE trial, a study of tenofovir-based preexposure prophylaxis with or without the oral antiretroviral therapy emtricitabine was conducted from September 2009 to August 2012. More than 5000 women aged 18 to 45 years who were from 15 clinical research sites in Uganda, Zimbabwe, and South Africa were randomized (1:1:1:1:1) to receive 1 of 5 treatments: oral tenofovir disoproxil fumarate, oral tenofovir with emtricitabine, oral placebo, 1% tenofovir vaginal gel, or placebo vaginal gel.