A new vaginal ring to prevent HIV

Despite the advances in treatment and biomedical intervention, HIV continues to spread at alarming rates among women in sub- Saharan Africa where who account for nearly 6 out of 10 adults infected. So identifying HIV prevention technology to meet their needs is said to be a critical tool in ending the epidemic.

The new vaginal ring made from silicone designed to deliver the anti-retroviral drug dapivirin to prevent HIV-1 has been recently announced and according to studies provides significant protection against HIV infection in women.

The monthly dapivirin vaginal ring is said to block HIV’s ability to replicate itself inside a healthy cell. These results were drawn from two large phase III clinical trials involving 2,629 African women between the ages of 18-45. The findings showed to reduce infection overall by 31 percent and 27 percent respectively compared to those assigned a placebo. In another study conducted by the Microbicides Trials Network-MTN, researchers found that among women who used the ring consistently, HIV risk was cut by at least 56 percent. In another subgroup of women who used the ring most, findings suggest their HIV risk was reduced by 75 percent.

While further studies will be needed to validate the results according to Dr. Elizabeth Brown a principal investigator at Microbicide Trials Network –MTN, this is good news for at risk and vulnerable women and girls who are not in fortunate positions to negotiate safe sex.

‘We have tested in South Africa, Malawi, Zimbabwe and Uganda for efficacy and for safety we have also done work in Tanzania and Kenya and those would be the countries where we would want to get country approvals first and then roll out’. Says Dr. Zeda Rosenberg, founder and CEO of International Partnership For Microbicides, the non-profit responsible for developing the dapivirin ring.

Rosenberg further explained that despite data collected and successful clinical trials, the product will still need to scale through WHO pre-qualifications and those of African countries regulatory bodies pushing the timeline for rollout to the middle of 2018 after a comparative dossier has been submitted.
Though most of the clinical trials were held within southern African countries, Rosenberg says, ‘We are looking at all of Africa and Nigeria especially because of the population. We will do it in a stage fashion but we certainly want to be accessible to all women at risk.’

Though the dapivarin ring is a welcome tool of intervention as the importance of multiple options to safeguard women’s lives goes without question, the decline in global HIV funding brings up the issue of affordability. Rosenberg believes that with relatively low investment the cost can go from seven dollars which is the cost at the initial launch down to as low as two dollars and five cents.

“ We will be looking to PEPFAR, Global Fund and the usual suspects on this. But the ring would have to be subsidised for the highest risk women.”
Wana Udobang is reporting from South Africa on a fellowship with the International Reporting Project (IRP)