Cambodia’s Doomed PREP Trial: What Happened Next?

via Speaking of Medicine, by Gavin Yamey

Remember the doomed PREP (pre-exposure prophylaxis) trial, examining whether tenofovir protects female sex workers (FSWs) from HIV, which was shut down by Cambodia’s Prime Minister in the face of pressure from activist groups? The serious public health implications of the trial’s termination were discussed in a 2004 PLoS Medicine essay:

“Speculation, unwarranted criticism, overreaction, or sensationalizing facts risk stigmatizing tenofovir and could jeopardize future attempts to find an efficacious PREP. This is in nobody’s interest.”

Last week, one of the Principal Investigators of that trial, Kimberly Page, gave a fascinating lecture at the University of California San Francisco, in which she told the audience how she turned the crisis of the trial’s shutdown into an opportunity.

The trial was literally shuttered overnight, said Dr Page, an epidemiologist who studies sexually transmitted infections (STIs). Fortunately, she said, “the NIH,” which funded the trial, “let me keep the money.”

A new research partnership was formed, which included community partners. Out of the ashes of the terminated PREP trial was born a new project, the Young Women’s Health Study (YWHS), which examines HIV risk factors among Cambodia’s FSWs.

Read the rest.

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