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Dapivirine vaginal ring gets nod for HIV prevention among women

Dapivirine vaginal ring

Kampala, Uganda |  THE INDEPENDENT | A vaginal ring that has been undergoing trials has been given approval by the European Medicines Agency to be used as an HIV prevention method among women who have tested negative.

The flexible vaginal ring which contains Dapivirine, an antiretroviral drug,  is inserted in the vagina and left there for 28 days. During this time, the ring continuously releases the antiretroviral drug to prevent HIV infections.

The ring has undergone three trials to determine its safety and efficacy. The trials include the ASPIRE and The Study drug trial that involved 4,500 women from Uganda, Zimbabwe, Malawi and South Africa. The trial in Uganda was conducted at sites in Masaka and Kampala, one led by the International Partnership on Microbicides and the other by the Microbicide Trials Network-MTN. 

At the end of the studies, scientists established that among women who appeared to use the ring most regularly, the HIV risk was cut by more than half across all analyses, and in some, by 75 per cent or more. The results from exploratory analyses of data suggest that even higher levels of protection can be achieved with regular and consistent use. 

Dr Joshua Musinguzi, the AIDS Control Programme Manager at the Ministry of Health says the results are welcome news and that will offer more protection for women. “This news is good. We have waited for it. The ring studies previously showed is effective and can help prevent new HIV infections better than other measures such as oral prep where adherence to the medication is an issue,” Dr Musinguzi said.

The AIDS Vaccine Advocacy Coalition (AVAC) welcomed the news from the European drug agency. Manju Chatani-Gada, the director of Partnership and Capacity Strengthening at AVAC says that approval of the ring will give women another option they can use to protect themselves.

“This is a long-awaited day for the thousands of women in Africa, Europe and the US, who participated in clinical trials of the ring and those of us who have advocated for access to the ring and other women-initiated prevention options for over two decades. Women have been waiting for additional HIV prevention options that they can use discreetly and easily, and for many, the ring could be that product,” Chatani-Gada said.

Women account for nearly 80 per cent of adults with HIV in Sub Saharan Africa, where unprotected, heterosexual sex is the primary driver of the epidemic. Despite advances in preventing HIV, Women, young girls especially, still face a disproportionate risk and a number of current prevention options, including oral Pre-exposure prophylaxis –PrEP, may not be accessible or practical for them.

According to UNAIDS, Uganda recorded a total of 53,000 HIV new infections in 2018. 14,000  of these belonged to women.  Dr Musinguzi says the vaginal ring might lead to a reduction of new infections.

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