There is an invention underway that will enable women protect themselves from HIV infection. This week, at the Pacific Health Summit in London, the final large-scale trial was officially launched of a vaginal ring which women can wear and forget about – at least for a month at a time – while it releases an HIV virus-killing drug called dapivirine.
The ring study, launched by the International Partnership for Microbicides, is already recruiting women in South Africa, Rwanda and Malawi. This is a phase III trial which will involve 1,650 women – enough to prove definitively whether it works. Small trials have already taken place in Africa to demonstrate its safety and to find out whether women are happy to use it.
Women who use the ring will forget that they are using it which means they don’t have to worry about it. the drug runs out every four weeks so they do have to remember every four weeks to go and change it for a new one.
The ring works by disseminating the antiretroviral drug into the tissues of the vagina, which prevents infection by HIV. It is safe to use a higher dose of drug than could be taken orally without toxic effects.
It has long been hoped that some sort of microbicide could be developed to help women protect themselves – if necessary without men knowing. But the trials of microbicides alone have been disappointing. The difference with the ring is that it uses antiretroviral drugs. Trials which showed that taking ARVs orally prevented people from becoming infected with HIV have given a boost to this approach.
And if the ring is shown to protect against HIV, the next step could be – a ring that protects against pregnancy as well. These vaginal devices are already used for contraception so it may be possible to combine contraception and antiretroviral drugs. And that would be a great result in Africa, where some studies have suggested that hormonal contraception increases the risk of HIV.
We really hope these trials work because women in Africa are disproportionately affected by HIV. the only problem with this invention is that women may forget to go back for a new one every four weeks. so how will they be reminded? mobile phone technology may be a good way to remind them but then again thats assuming they have access to a phone. it may be difficult to retain some women but hopefully if this is successful and these women are comfortable with the ring and see the benefits, retention may not be a big problem afterall.