ArticleJournal of acquired immune deficiency syndromes (1999)2011
Epidemiological impact of tenofovir gel on the HIV epidemic in South Africa.
Article in Journal of acquired immune deficiency syndromes (1999), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- Evolving landscape of economic evaluations of HIV pre-exposure prophylaxis and pre-exposure prophylaxis implementation strategies: a systematic review.Journal of the International AIDS Society · 2025Pooled it
- Costs and Cost-Effectiveness of Biomedical, Non-Surgical HIV Prevention Interventions: A Systematic Literature Review.PharmacoEconomics · 2023Pooled it
- The cost and impact of scaling up pre-exposure prophylaxis for HIV prevention: a systematic review of cost-effectiveness modelling studies.PLoS medicine · 2013Pooled it
- Measuring adherence by visual inspection of returned empty gel applicators in the CAPRISA 004 microbicide trial.AIDS and behavior · 2014Trial
- Safety of coitally administered tenofovir 1% gel, a vaginal microbicide, in chronic hepatitis B virus carriers: results from the CAPRISA 004 trial.Antiviral research · 2013Trial
- Cost-effectiveness of HIV Prevention Interventions in Sub-Saharan Africa: A Systematic Review.EClinicalMedicine · 2019Article
- Does alcohol use have a causal effect on HIV incidence and disease progression? A review of the literature and a modeling strategy for quantifying the effect.Population health metrics · 2017Review
- Historical development of vaginal microbicides to prevent sexual transmission of HIV in women: from past failures to future hopes.Drug design, development and therapy · 2017Review
- Parameterising User Uptake in Economic Evaluations: The role of discrete choice experiments.Health economics · 2016Article
- Article
- An action agenda for HIV and sex workers.Lancet (London, England) · 2015Review
- PrEP Implementation Science: State-of-the-Art and Research Agenda.Journal of the International AIDS Society · 2015Article
- Translating PrEP effectiveness into public health impact: key considerations for decision-makers on cost-effectiveness, price, regulatory issues, distributive justice and advocacy for access.Journal of the International AIDS Society · 2015Article
- Pre-exposure prophylaxis in Southern Africa: feasible or not?Journal of the International AIDS Society · 2015Article
- Microbicides and their potential as a catalyst for multipurpose sexual and reproductive health technologies.BJOG : an international journal of obstetrics and gynaecology · 2014Review
- Adherence challenges with drugs for pre-exposure prophylaxis to prevent HIV infection.International journal of clinical pharmacy · 2014Review
- Cost-effectiveness of tenofovir gel in urban South Africa: model projections of HIV impact and threshold product prices.BMC infectious diseases · 2014Article
- ARV-based HIV prevention for women - where we are in 2014.Journal of the International AIDS Society · 2014Review
- Review
- Rectal transmission of transmitted/founder HIV-1 is efficiently prevented by topical 1% tenofovir in BLT humanized mice.PloS one · 2013Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundTenofovir gel, an antiretroviral-based vaginal microbicide, reduced HIV acquisition by 39% in women in a recent randomized controlled clinical trial in South Africa.
methodsTo inform policy, we used a dynamical model of HIV transmission, calibrated to the epidemic in South Africa, to determine the population-level impact of this microbicide on HIV incidence, prevalence, and deaths and to evaluate its cost-effectiveness.
resultsIf women use tenofovir gel in 80% or more of sexual encounters (high coverage), it could avert 2.33 (0.12 to 4.63) million new infections and save 1.30 (0.07 to 2.42) million lives and if used in 25% of sexual encounters (low coverage), it could avert 0.50 (0.04 to 0.77) million new infections and save 0.29 (0.02 to 0.44) million deaths, over the next 20 years. At US $0.50 per application, the cost per infection averted at low coverage is US $2392 (US $562 to US $4222) and the cost per disability-adjusted life year saved is US $104 (US $27 to US $181); at high coverage the costs are about 30% less.
conclusionsOver 20 years, the use of tenofovir gel in South Africa could avert up to 2 million new infections and 1 million AIDS deaths. Even with low rates of gel use, it is highly cost-effective and compares favorably with other control methods. This female-controlled prevention method could have a significant impact on the epidemic of HIV in South Africa. Programs should aim to achieve gel use in more than 25% of sexual encounters to significantly alter the course of the epidemic.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.