Vaginal Ring Provides Significant Protection Against HIV- Study Confirms

A vaginal ring that delivers an antiretroviral drug is highly effective at protecting women from HIV, albeit used properly and consistently for a month at a time, confirms a new exploratory analysis of data from the ASPIRE study.

Developed by the nonprofit International Partnership for Microbicides (IPM), the simple white vaginal ring contains an antiretroviral (ARV) drug called dapivirine. Once the flexible ring is inserted into the vagina, it steadily releases the medication which helps in thrashing the human immunodeficiency virus (HIV), and thus protects women against the deadly virus that causes AIDS.

Each ring consists of 25 mg of the ARV dapivirine and about 4 mg of the medication gets released over the course of the month. The monthly vaginal ring is meant to be used for a month at a time, and women can easily insert and remove it on their own.

In the ASPIRE study, which was a Phase III trial, researchers recruited 2,629 women ages 18-45 from Malawi, Uganda, South Africa and Zimbabwe, and divided them into two groups. Women in the first group were assigned to use the dapivirine ring, while those in the other group were given a placebo ring to use that contained no medication.

They found, women who appeared to use the ring most consistently their risk of catching the lethal virus was reduced by more than 50 percent, and in some cases, by a whopping 75 percent or more.

“Adherence to HIV prevention strategies is not always perfect, and we knew that not all women used the ring consistently, so we developed an analysis to explore the degree of HIV protection that was associated with more consistent use,” explained Elizabeth R. Brown, Sc.D., from the Fred Hutchinson Cancer Research Center and University of Washington in Seattle. “Across all analyses we saw high adherence was associated with significantly better HIV protection.”

Brown is the principal investigator of the National Institutes of Health (NIH)-funded Microbicide Trials Network’s (MTN) Statistical and Data Management Center (SDMC).

“We are encouraged by these new analyses, which further support that the dapivirine ring could be an important option for women who urgently need new tools to protect themselves from HIV,” said Dr. Zeda Rosenberg, chief executive officer of the IPM, the developer as well as the regulatory sponsor of the vaginal ring.

While Dr. Brown and her colleagues hail the new results as encouraging, they admit there are inherent limitations in such kinds of exploratory analyses, and that further analysis is required to validate the current outcome.

The fresh data analyses from the ASPIRE study was announced Monday, July 18 at The International Conference on AIDS (AIDS 2016) in Durban, South Africa, and were published online in the New England Journal of Medicine.