Finally! A Dual-Purpose Prophylaxis Vaginal Ring

A new vaginal ring containing both the anti-retroviral drug, dapivirine, and a hormonal contraceptive, levonorgestrel, could give women a single pre-exposure prophylaxis that shields them from both HIV and unintended pregnancy.

Microbicide Trials Network, an international collaboration of clinical trials that is funded by The National Institutes of Health, is overseeing this Phase I trial, after two larger trials — ASPIRE and The Ring Study — verified the durability of monthly dapavirine rings. 

The newest study is testing whether the ring will be able to provide a three-month supply of the two drugs. It will be conducted at Magee-Womens Hospital of the University of Pittsburgh School of Medicine and the University of Alabama at Birmingham. 

It wasn’t until women who participated in previous ring trials expressed a need for a dual-purpose prophylaxis that researchers reportedly embraced the idea. 

Both previous studies involved women wearing a vaginal ring for four weeks at a time. When used correctly, NAM’s AIDSMap reported such rings to be 75 to 92 percent effective in preventing HIV among women. 

However, at last year’s International AIDS Conference, ASPIRE researchers acknowledged more dubious results, reducing HIV transmission by 56 percent in women 22 to 26, and 51 percent for women over 27, but having zero effect for women 18 to 21.

Researchers argued the problem was adherence, and have pressed on. That’s because the ring symbolizes the first long-lasting, easy-to-use, HIV prevention women can discreetly employ. That is particularly important in situations — or parts of the world — where women may not have sexual autonomy or the ability to insist their partner uses protection.

If all goes well, Dr. Sharon L. Achilles, director of the University of Pittsburgh Center for Family Planning Research told reporters, the study will determine whether a duo-purpose ring could last “longer — for up to three months — as it was intended.”

Results are expected mid-2018. “This study is a critical first step on a pathway that we hope will ultimately enable us to provide women with an easy-to-use product that can provide safe and effective, long-acting protection against both HIV and unintended pregnancy,” Achilles concluded.