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Kenyan women who used to take a daily HIV prevention pill have admitted to have lied to researchers that they swallowed all the tablets.
More than 700 women in Bondo, Siaya county, and almost a similar number in Pretoria, South Africa, had been put on the pill, but it was not seen to reduce the rate of HIV infection as expected. Consequently the study was stopped.
Interviewed several times, the women were adamant they had religiously swallowed the pills as prescribed, but when researchers analysed their blood, there was no such evidence.
In a report published in the April issue of the Journal of the Acquired Immune Deficiency Syndrome, the women revealed that they actually never took the pills. More than a third have owned up to throwing them away, while others say they gave them out to friends, some who were HIV positive.
“The majority of the participants said their colleagues had counted and removed pills from their bottles to be seen to be following instructions,” says the study by Family Health International (FHI360).
The pill Truvada, an anti-viral drug for people infected with HIV, is also prescribed to healthy people thought to be at high risk of contracting HIV in what is called Pre-Exposure Prophylaxis (PrEP).
Truvada, made by the American biotechnology company Gilead Sciences, forms a significant part of the Sh1.7 trillion road-map government initiative to eliminate HIV and Aids by 2030. The initiative was launched last year by the Health Cabinet Secretary, Mr James Macharia, and among others, proposes to put HIV high risk groups such as prostitutes, gays and drug injectors on PrEP.
A contemplative budget, prepared for the government by the US-funded Health Policy Project and the National Aids and STI Control Programme, indicates the country could spend as much as Sh4 billion annually to supply prostitutes with Truvada.
However, the new study indicates the money could end up in the hands of undeserving cases, for instance, people who are already infected.
Truvada has been opposed on the basis that healthy people cannot religiously stick to taking medication for a disease that may affect them in future. Last year the Los Angeles-based Aids Healthcare Foundation, which has branches in Nairobi, had written to the World Health Organisation, warning against the widespread use of Truvada in HIV prevention.
The foundation, which in May opened a multi-million shilling regional head office in Parklands, Nairobi, has also embarked on a campaign cautioning individuals, groups and government agencies against a widespread scale-up of the pill.
The organisation cites eight studies, one of them conducted in Kenya, showing that healthy people are not ready and willing to religiously swallow a pill daily to prevent HIV infection, even where they are paid to do so.
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