Findings from two African trials, presented February 22 at the Conference on Retroviruses and Opportunistic Infections (CROI), showed that a vaginal ring containing the antiretroviral drug dapivirine can reduce women's HIV risk by as much 60 percent in women aged 25 and older. Microbicide proponents and HIV activists heralded these findings as a breakthrough that offers women greater self-protection against HIV. But some conference participants labeled the results “disappointing," pointing to the much lower levels of protection found among younger women.
Over 4,500 women in four sub-Saharan African countries participated in the two studies, ASPIRE (A Study to Prevent Infection with a Ring for Extended Use) and The Ring Study. The studies also found an overall reduction in HIV risk of 27 percent and 31 percent, respectively. For women under age 21, however, the ring offered minimal protection--a finding believed to result from inconsistent use.
Despite these mixed results, researchers, activists, and women themselves hail the possibility of a woman-controlled option for self-protection as “revolutionary.” Unlike condoms and other HIV prevention methods, women themselves can opt to use the vaginal ring, without informing or seeking approval from their partner. The device can be left in place for a month.
Researchers anticipate further research on the ring before its broader release--including studies on combining microbicidal and contraceptive functions, and on longer-lasting protection. While research and licensing will likely take a year or more, advocates look forward to better understanding of the potential of dapavirine vaginal rings as an exciting tool for women’s self-protection against HIV.
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