Vaginal ring to prevent HIV on the cards

The results of two ground-breaking 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 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 per cent  – 30 per cent relative reduction in HIV incidence. A surprising 56 per cent 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.

With approximately 6.8 million people living with HIV in South Africa and nearly 60 per cent 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. 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.

“The once-off 20-30 minute procedure reduces a man’s lifetime risk of acquiring HIV by up to 60 per cent. 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.

“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.