Daily HIV prevention pill leading to contraceptive failure

By Gatonye Gathura


A study in Western Kenya shows high rates of pregnancy in women using the injectable contraceptive alongside the daily HIV prevention pill.

Researchers analyzed blood samples from 62 women in Bondo who were on both medications and found low levels of the active ingredient of the contraceptive than expected. They also got reports of higher rates of pregnancies in this group than expected.

The researchers were not sure why the higher rates of pregnancy but suggest the quality of the many brands of injectables in the Kenya market be investigated.

The team from FHI 360, US, and Bill & Melinda Gates Foundation do not rule out some kind of unhealthy interaction between the injectable, in this case Femiplan, distributed by Population Services International, and Truvada the HIV prevention pill.  The report was published last Tuesday in the journal Contraception.

More than 1,000 prostitutes are on a government sponsored programme for Truvada and plans are underway to roll it out to the public.

In October a study presented at the American Society of Nephrology showed kidney failure to be high among HIV patients using Truvada for treatment.


“Infectious disease specialists and clinicians should be aware of the risk of kidney poisoning related to its use as it could lead to, Acute Kidney Injury,” lead researcher Teg Marcos Veiga had told the meeting.


A budgetary estimate has been prepared for the Kenya Government by the US funded Health Policy Project in Nairobi that could see the public spend about Sh4 billion annually on the pill and other HIV related biomedicals.

But apart from the rationale of providing healthy individuals with a drug well known for its toxicity, prostitutes so far in Kenya have given the pill a wide berth.

Several studies in Kenya show a slow uptake even in research environments. A recent study by Canadian and Kenyan researchers among sex workers in Nairobi showed poor up take of the pills despite them being freely available at selected clinics in the city.


Writing in the journal Aids in September the researchers from the University of Toronto, University of Nairobi, Kenya and the University of Manitoba, Canada said even among those collecting the pills only a third completed the required dose.

The researchers had interviewed 130 HIV negative prostitutes in Nairobi and only 35 per cent completed a full course of treatment.

A another report published in the April issue of the Journal of the Acquired Immune Deficiency Syndrome, showed that many women who collected the pills in a Nyanza trial in Kenya 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 question being raised through these studies is whether healthy people will readily take a daily dose of Truvada for HIV prevention.

Rocket Science

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