The use of PrEP among men who have sex with men in the U.S. Rather than exclude cisgender women from participating in the Descovy trials, Gilead could have and should have invested in formative work and community engagement to ensure successful recruitment of this important group for HIV prevention.
Given Gilead’s earnings and past spending on HIV drug research and development, the company is more than capable of addressing the “challenges” of including cisgender women in PrEP clinical trials. Yet even though they bear a significant burden of the HIV/AIDS epidemic, women still do not have equitable access to HIV prevention and treatment, nor equitable opportunities to participate in HIV research. The fact that women are more likely to acquire HIV stems from a confluence of factors, including structural forces that disproportionately impact women, from poverty and lack of education to sexual and gender-based violence and restrictive laws that limit women’s ability to protect their sexual and reproductive health. I have seen firsthand the effect of HIV on women, as well as the lack of funding and institutional support for research on women. I have spent nearly 10 years working in HIV research and now lead the New York City Health Department’s Bureau of HIV, in addition to being a primary care physician and HIV specialist. Gilead’s approach is incredibly disappointing.
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