Vaginal Ring And HIV

According to a study published in the New England Journal of Medicine, investigators suggested that vaginal ring can protect against HIV infection by the continual release of an antiretroviral drug. CDC (Centers for Disease Control and Prevention) speculates that over 1,218,400 individuals (aged 13 and above), in the US are victims of HIV virus. Unfortunately, more than 12.8% of HIV population remains unaware of their HIV status.

HIV Infection And ASPIRE Study

Back in 2014, 25.8 million people fell victim to HIV virus in sub-Saharan Africa and it was suggested that over 50% of this figure comprised of women. Statistics indicates that this infection is more common in young women and adolescent girls. Therefore, a preventive study (referred to as MTN-020 or ASPIRE HIV protection), investigated how vaginal rings can prove effective in releasing the drugs to fight off the HIV infection. The clinical trial involved 15 sites of 4 sub-Saharan African countries like Zimbabwe, Uganda, South Africa and Malawi. The aim of this study was to investigate whether vaginal silicon ring (that is capable of continual release of Dapivirine drug) could provide protection against HIV infection. Ring replacement occurred every 4 weeks.

The data collection for ASPIRE study began in 2012 and consisted of 2,629 women participants with age ranging between 18-45 who were potentially at risk of developing HIV infection. The data sampling ended in September 2015. The women were divided into two groups randomly. The test group received a vaginal ring that was designed for the continual release of Dapivirine in the dose of 25 mg; whereas the control group was given a placebo ring.

The participant women and their partners were given HIV prevention services that included counseling for reducing HIV infection risk, free condoms, HIV testing and treatment for STIs (sexually transmitted infections).

Results Of The Study

The findings of the study suggested that vaginal ring lowered the overall risk of HIV infection by up to 27%. The risk lowered all the way to 61% in case of women aged over-25 due to consistent use of the ring. Two of the sites showed least adherence therefore after final evaluation of the data it was found that vaginal rings reduce 37% of the overall risk of HIV infection in women who adheres to it on regular basis.

Dapivirine present in the ring provided no evident protection in the age group below 25 which may be due to the inconsistent use of the ring, as suggested by the lowered Dapivirine level in their blood sample. The Dapivirine treatment didn’t potentiate the rate of adverse effects neither did it produce any effect on the antiretroviral resistance frequency in participating women who later acquired HIV.

The findings have opened new doors to the protective approach against HIV infection. However, the use of vaginal ring for preventing HIV infection still needs detailed and large-scaled investigation.

Another similar study called The Ring Study found promising results of 31% effectiveness with the use of vaginal rings. It also found the risk of HIV infection to decrease slightly in women above 21 years of age. Experts are hoping that rings containing acyclovir will help combat the HIV infection more effectively.

References

• Baeten, J. M., Palanee-Phillips, T., Brown, E. R., Schwartz, K., Soto-Torres, L. E., Govender, V., ... & Siva, S. (2016). Use of a vaginal ring containing dapivirine for HIV-1 prevention in women. New England Journal of Medicine, 375(22), 2121-2132.