A study published in the New England Journal of Medicine suggests that a new method of antiretroviral delivery might serve as a potent form of protection against HIV for women. The HIV drug dapivirine is now available in a ring, which is inserted within the vagina, and provides extended protection.
The study, dubbed ASPIRE (“A Study to Prevent Infection with a Ring for Extended Use”), was a phase three clinical trial that took place in Africa among sexually active, but not pregnant cisgender women ranging from 18-45 years old. It was conducted by the Microbicide Trials Network, an organization funded by the National Institute of Allergy and Infectious Diseases (NAID).
Overall, the ring was 27 percent effective among all the women enrolled in the study. That sucess rate rose to 37 percent when scientists removed data from two study locations, where “It was apparent early on that many women were not returning for study visits or using the ring consistently.”
When looking at the age spread, results from the study showed that the use of the ring was able to lower the rate of HIV infection by 61 percent in women 25 and older, but it proved less effective with women 18-24. That disparity was due to no fault of the ring. Based upon the amount of dapivirine in their blood streams, the researchers concluded that younger women were using the ring less consistently.
The research was conducted as part of the effort to stem the rising tide of HIV infections among women in Sub-Saharan Africa, home to 80 percent of all the women in the world living with HIV. According to a 2011 United Nations study, rape is also a major issue in the region where frequent conflicts serves as harbingers of sexual violence targeting women.
The ring is nowhere near as effective as PrEP in preventing HIV, but women in Sub-Saharan Africa have little or no chance of accessing PrEP. The ring offers women a form of HIV prevention that is under their control and doesn't rely the use of condoms by sexual partners; which makes it a life saving device in a region racked by sexual violence.