Vaginal rings could be an alternative tool in the fight against HIV, as new research shows the device significantly reduced rates of HIV transmission in high risk groups. The study of 2629 women in Malawi, South Africa, Uganda and Zimbabwe found that women who had a vaginal ring containing Dapavirine were 37% less likely […]
Vaginal rings could be an alternative tool in the fight against HIV, as new research shows the device significantly reduced rates of HIV transmission in high risk groups.
The study of 2629 women in Malawi, South Africa, Uganda and Zimbabwe found that women who had a vaginal ring containing Dapavirine were 37% less likely to contract HIV-1 than the placebo group if adherence was good.
“African women bear a disproportionate burden of the global HIV-1 epidemic. In the placebo group in our trial, the annualized HIV-1 incidence was more than 4%, despite monthly HIV-1 testing and risk-reduction counseling, testing of male partners, screening and treatment of sexually transmitted infections, and provision of free condoms,”
“Our results show that a vaginal ring containing an antiretroviral drug can provide some protection against HIV-1 acquisition.”
The randomised, double-blind trial targeted women in Africa, where prophylaxis antiviral medications like PrEP have made poor inroads in reduced HIV transmission, likely due to low adherence.
Women had to return to the centre monthly to renew their 25 mg of Dapivirine ring.
Over the 15 trial sites, 71 women in the dapivirine group contracted HIV compared to 97 in the placebo group (3.3 and 4.5 per 100 person-years, respectively).
However, two of the study sites had low rates of retention and adherence. When these were excluded from the analysis the rate of protection was 37% higher in the Dapavirine group compared to the placebo group.
Interestingly, the rings conferred better protection in women over-21, likely due to better adherence, the authors wrote.
Adverse events were similar in both groups.
NEJM, 2016; online 22 February
