United States Ending the Human Immunodeficiency Virus (HIV) Epidemic plan: evaluation of the role of industry funding in published pre-exposure prophylaxis (PrEP) literature

Author:

Gupta Somya,Granich ReubenORCID

Abstract

Pre-exposure prophylaxis (PrEP) is integral to the US End of AIDS strategy. However, low adherence, high costs, frequent testing and monitoring side effects make delivery of PrEP complicated. Gilead has sponsored PrEP-related research efforts and access as part of its marketing efforts. We review potential conflict of interests (COI) in the scientific literature for the US PrEP related articles to understand the impact of Gilead’s corporate sponsorship.We identified 93 US PrEP articles published in the top 10 medical journals and top 10 HIV/AIDS journals in 2018. There were 289 first three and senior authors in these articles, of which, 34 (11%) declared a Gilead COI and 28 (10%) had undeclared Gilead COI. Only 10 authors accounted for 50% of the articles, with 70% of them having potential COI including receiving grants, fees and study drugs. The 93 articles were associated with 51 leading institutions (institution of three or more authors or participating institutions in a trial). Authors from 12 (24%) institutions declared an institutional Gilead COI and 22 (45%) institutions had undeclared Gilead support. Overall, of the 93 included articles, 30 (32%) had declared Gilead COI. Combining declared and undeclared COIs for authors and institutions provided an overall 83 (89%) articles with a potential Gilead COI. Of the 93 articles, 60 (71%) had favorable conclusions in 60 (71%). Declared Gilead support was significantly associated with favorable article conclusions (p<.05) but combined declared/undeclared author and/or institutional Gilead support was not associated with favorable conclusion. Nearly 90% of US PrEP articles had Gilead support and authors failed to report individual or institutional COI in 70% of articles. Direct corporate support is important for scientific research. However, Gilead’s marketing push for PrEP, undeclared COI, and potential influence of Gilead supported authors are of concern given the potential impact on the scientific discourse and the US HIV control strategy.

Publisher

Center for Open Science

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