New HIV protection for women on the cards
South African women have new hope they will not contract HIV, after two trials of vaginal rings that secrete an ARV drug protected one in three women from the virus.
In Africa, young women can have up to 8 times higher HIV rates than their male counterparts. Local and international researchers have spent many years and millions of dollars trying to find a product that helps women protect themselves from HIV. Most products have failed.
Additionally, many women cannot convince their partners to wear condoms.
But last night, at the Boston Conference on Retroviruses and Opportunistic Infections, Scientists released results from two trials showing vaginal rings that release ARVs reduced the chance of women get HIV by 30%. The rings were tested in two concurrent trials that both took three years and involved more than 8,000 women, many of them from South Africa.
The rings fit high up into the vagina and release a slow-acting ARV drug called Dapivirine that protects cells from HIV by stopping the virus from replicating.
The rings have to be replaced once a month and cannot be felt during sex.
In women older than 21, who used the rings consistently, and did not remove them, they worked to reduce the risk of HIV 56% - or protected one in two women.
South African researcher from International Partnership on Microbicides Annalene Nel, who led one of the trials, said: "These are two pivotal trials - showing safety and effectiveness [of prevention product for women] This is the first time two trials together have shown that a women's prevention products works."
“The results are statistically significant,” said the head of one of the studies, Dr Jared Beaten from the University of Washington.
Nel said scientists would approach the South African Medicines Control Council to licence the rings.
At the same time. the European Medicines authority is being asked to look at licencing the rings. Regulatory approval , if granted, could take about two years.
Scientists are hoping a product will be on the market by the beginning 2019.
Previous trials of an ARV gel that women could apply to their vagina failed.
A trial of 7,000 women in South Africa and other parts of Africa using an ARV gel that had to be applied before sex didn't work because most women didn't use the gel. The rings worked better because they are more convenient to use.
But the rings did not prevent HIV in young women aged 18 to 21.
This is because blood tests and examination of rings after use revealed young women under 21 didn't use them consistently said researcher Thesla Palanee-Phillips, from Wits Reproductive Health and HIV Institute.
"If you don't use the ring, you are not likely to be protected. In the same way it you don't take any other medicine, it also won't work."
Nel said the SA Department of Health had told her that women under age 21 also were also the least likely to use birth control pills or condoms. Follow-up studies are planned to find out how to help women under the age of 21 use birth control and HIV prevention options more regularly.
Advocacy Group AVAC director Mitchell Warren said of the results. “It’s clear that the dapivirine vaginal ring can be a viable option for women to protect themselves from HIV by using the ring consistently."
But he said younger women in Sub-Saharan Africa remain at substantial risk of HIV so governments must roll out oral prevention to them. For example, a pill taken once a day, called Truvada, offers up to 90% protection from HIV if taken consistently. He urged this to be made available to women in Sub Saharan Africa.