2024-01-04 14:38:45
A New Approach to HIV Prophylaxis: The Dapivirine Vaginal Ring
Young women and girls are the demographic most at risk for HIV globally. Between the ages of 15 and 24, they are more than twice as likely to become infected with HIV as young men. Women often have no control over whether their sexual partner uses a condom, putting them at further risk of HIV. However, access to oral PrEP is often denied. A new solution could be the dapivirine vaginal ring, which is intended to protect against not only unwanted pregnancies, but also HIV infections.
The dapivirine ring is a silicone matrix containing 25 mg of the non-nucleoside reverse transcriptase inhibitor (NRRTI) dapivirine. It must be worn for 24 hours before reducing the risk of HIV infection and remains intravaginally throughout the month. The ring is intended to be used with most contraceptives and should also be combined with a condom to prevent the transmission of other STDs.
Large phase 3 studies have reported that the dapivirine vaginal ring is around 30% effective in preventing HIV infection. However, inadequate treatment adherence can reduce its effectiveness, as seen in the group of 18-21-year-old women.
A recent DREAM study was conducted to further investigate this issue, and HIV-negative women from the phase 3 study were included. The follow-up period was at least 12 months, and only 9% of the enrolled participants dropped out of the study early, with the most common reasons being HIV seroconversion and work-related circumstances.
The ring is currently not approved for use in pregnant and breastfeeding women, but studies have found that it poses no significant safety concerns for these groups. Regulatory approval has been given in 11 countries in eastern and southern Africa, and the ring is currently being offered to women through more than 30 implementation and pilot studies in six countries. Negotiations with the manufacturer, Kiara Health, are underway to reduce the costs and make the product available to more women.
A strategic partnership is being discussed to expand local production capacities and make the product available to a broader audience. The company is also working on a longer-acting successor product that will only have to be changed every three months, reducing costs and simplifying use. Development of this longer-acting ring is expected to be completed and submitted for regulatory approval in the next 12-18 months.
The dapivirine vaginal ring offers a promising new approach to HIV prevention for women and girls in regions most at risk, providing a discreet and effective method to reduce the risk of HIV infection.
Sources:
1. NIH/National Institute of Allergy and Infectious Diseases, Unsplash]
#vaginal #ring #protects #HIV