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Amid concern that HIV prevention pills are not being widely taken by those at highest risk of infection, AIDS activists hope that a trial getting underway in a federal courtroom this week will help explain why the medicine has struggled to see uptake.

The litigation accuses Gilead Sciences of using a range of controversial business tactics that led the U.S. health care system to overspend for HIV medicines. These included pay-to-delay settlements of patent litigation and moves that purportedly stalled development of safer versions of medicines that had years left of patent protection.

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The actions allegedly stem from different agreements that Gilead, which dominates the market for HIV medicines, reached with other drugmakers. Due to their complex nature, though, the litigation was split into two different trials. The first trial, which began this week in a federal court in San Francisco, involves a deal between Gilead and Teva Pharmaceuticals, one of the largest purveyors of generic drugs.

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