journal homepage: www.elsevier.com/locate/hlpt Available online at www.sciencedirect.com Tenofovir gel for HIV prevention for women: Perspectives of Key Opinion Leaders from India Abhijit Prabhughate a,1 , Avina Sarna b,n , Martha Brady c,2 a Consultant C 202, 1st floor (front), Sarvodaya Enclave, New Delhi 110017, India b Population Council, Zone 5A, Ground Floor, India Habitat Centre, Lodi Road, New Delhi 110003, India c Population Council, One Dag Hammarskjold Plaza, NY 10017, USA Available online 15 November 2013 KEYWORDS Microbicides; HIV prevention; ARVs; Tenofovir gel; India; Key Opinion Leaders Abstract Objectives: Country decision-making regarding adoption of new health technologies is a lengthy process that is informed by scientific, public health, and policy analyses. Key Opinion Leaders (KOLs), who include a range of influential individuals (e.g., Ministry of Health officials, leaders of medical and pharmacy associations, civil society representatives, donors), play a critical role in country decision-making around adoption and availability of new HIV-prevention tools. Their perspectives can shape public opinion and influence policy, programming, and procurement decisions. Methods: In-depth face-to-face interviews with a dozen purposefully selected national KOLs in India were conducted to gain their perspectives around ARV-based prevention for women, focusing on microbicides in general and tenofovir vaginal gel specifically. Theme-based content emerged and was analyzed using ATLAS.ti software. Results: While generally supportive, KOLs expressed caveats regarding the role tenofovir gel might play in the overall HIV-prevention program. Key outstanding issues that would need to be addressed include product effectiveness, potential for resistance, product cost, feasibility of HIV testing and re-testing, and effective targeting of key populations for public health impact. Conclusions: As new HIV-prevention technologies advance through clinical trials, there is a concomitant necessity to engage in policy analysis exercises. Formative research with stakeholders early in the process is an important yet often overlooked step. The potential role that the tenofovir gel could play in India will depend in large part on epidemiological, public health, and economic factors. Understanding target populations' perspectives on the product will also be critical for its successful introduction. & 2013 Fellowship of Postgraduate Medicine. Published by Elsevier Ltd. All rights reserved. Introduction Although HIV continues to spread in many settings, during the last decade several countries have made important progress in addressing the epidemic [1]. India's strong 2211-8837/$ - see front matter & 2013 Fellowship of Postgraduate Medicine. Published by Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.hlpt.2013.11.002 n Corresponding author. Tel.: + 91 11 2464 2901; fax: + 91 11 2464 2903. E-mail addresses: abhijitpg@gmail.com (A. Prabhughate), asarna@popcouncil.org (A. Sarna), mbrady@popcouncil.org (M. Brady). 1 Cell: + 91 844 774 9291. 2 Tel.: + 1 212 339 0618; fax: + 1 212 655 7052. Health Policy and Technology (2014) 3, 59–65