HIV/Aids

17 March 2016

Vaginal ring to prevent HIV on the cards

A vaginal ring that slowly oozes an experimental HIV virus-blocking drug named dapivirine into the surrounding vaginal tissue is being tested in Africa.

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The results of two groundbreaking studies that have just been released at the annual Conference on Retroviruses and Opportunistic Infections (CROI) show that there may be a promising HIV prevention option for women in the form of a vaginal ring. The ring, which is used for a month at a time, contains the antiretroviral drug dapivirine that inhibits the HIV virus from multiplying.

Women need options

Women aged 18 to 45 in South Africa, Uganda, Malawi and Zimbabwe were involved in the trials. Women who were assigned the dapivirine ring showed a 27%–30% relative reduction in HIV incidence. A surprising 56% reduction was seen in women older than 21 years of age.

Linda-Gail Bekker, one of the authors of the study, says: “We can really build on these important results. Globally women need options to protect themselves from HIV  acquisition. The dapivirine vaginal ring is one such option.”

The study demonstrated that the vaginal ring was safe and effective for HIV prevention in women. This study is the first to demonstrate HIV protection from a sustained-release approach of an antiretroviral, which is considered a breakthrough.

Read: Vaginal ring offers partial HIV protection

With approximately 6.8 million people living with HIV in South Africa and nearly 60% being women – this is a female-controlled HIV prevention method that can potentially reduce new infections among women.

Researchers and health authorities now have to start the process of getting the ring approved in order to make it accessible and affordable to the public.

Once-off 20–30 minute procedure

It could be years before the ring joins other HIV prevention options such as condoms, oral pre-exposure prophylaxis and Voluntary Medical Male Circumcision (VMMC).

VMMC is currently available and shows similar levels of protection among men. VMMC also has the added benefits of being a once-off intervention and does not have adherence challenges.

Read: HIV medication side effects

“The once-off 20–30 minute procedure reduces a man’s lifetime risk of acquiring HIV by up to 60%. VMMC also reduces the risk of acquiring human papilloma virus (HPV), and as a result reduces the risk of penile cancer in those circumcised and reduces the risk of cervical cancer among the female partners of circumcised males,” says Marina Rifkin, the Public Health Specialist at CareWorks, an HIV management organisation.

“As an HIV management organisation, we promote VMMC as part of a combination prevention strategy to prevent the spread of HIV, this includes: correct and consistent condom use, early treatment of sexually transmitted infections, partner reduction, encouraging youth to delay sexual debut, the provision of antiretroviral treatment for people living with HIV, and hopefully one day this vaginal ring.

Read: Basic management and monitoring of HIV infection

“As a country, we have the highest HIV burden in the world with approximately 400 000 new HIV infections annually. While these results of the vaginal ring trial are encouraging, it shouldn’t deter the public from making use of what we have available now. South Africa would benefit greatly from having more men circumcised, as this not only lowers the risk of HIV acquisition among men, but it also reduces the risk of men transmitting the infection, which ultimately protects women against exposure to HIV as well,” concludes Rifkin.

To find out more information or where you, your son, friend or partner, can undergo free VMMC: send a free "please call me" to 0606 800 800 and a counsellor will get back to you. 

Read more: 

What is HIV/Aids? 

Symptoms of HIV/Aids 

Prevention of HIV infection

 

Ask the Expert

HIV/Aids expert

Dr Sindisiwe van Zyl qualified at the University of Pretoria before working for an HIV/AIDS NPO in Soweto for many years. She was named one of the Mail & Guardian's Top 200 Young South Africans in 2012.

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