Chronicle Editor
Thandeka Moyo-Ndlovu, Health Reporter
THE world’s first vaginal ring for prevention of HIV may soon be available for women in Zimbabwe.
The Dapivirine vaginal ring (DPV-VR) has been recommended by the World health Organisation (WHO) as an additional HIV prevention measure for women, whose risk of contracting HIV is three times higher than that of men.
Clinical studies have shown that consistent use of the ring can reduce the risk of contracting HIV by more than 50 percent.
It can be offered alongside oral pre-exposure prophylaxis (PrEP) as a choice for women who do not want or are unable to take a daily oral tablet.
The DPV-VR is the first vaginal HIV prevention product as contraceptive vaginal rings have been available for years in other countries.
One of the clinical trials to prove DPV-VR efficiency was carried out in Zimbabwe where it was proved that the ring is more than 60 percent effective in preventing HIV.
Dapirivine belongs to a class of ARVs that prevent HIV from making copies of itself and the ring is made of flexible material which sits high inside the vagina where it slowly releases the drug over a course of the month the ring is worn.
So far, members of the public can choose from eight HIV prevention methods which have been scientifically proven to reduce risk.
These include treatment as prevention, a process where HIV positive people are treated with antiretroviral medication which upon suppressing the viral load makes it difficult for one to transmit HIV.
Other options include condoms, ART, oral PrEP, abstinence, voluntary medical male circumcision, HIV testing and counselling.
HIV prevalence among adults in Zimbabwe is 12,9 percent which corresponds to approximately 1 225 000 adults living with HIV and women remain the most affected gender.
Statistics show that in Zimbabwe, the annual incidence of HIV among adults stands at approximately 31 000 new cases of HIV and it is higher in women.
The WHO announcement comes amid the ongoing 4th HIV Research for Prevention virtual Conference where more than 1 700 experts, scientists and delegates are discussing recent findings on HIV prevention measures towards the global goal of ending the pandemic by 2030.
“WHO today recommended that the dapivirine vaginal ring (DPV-VR) may be offered as an additional prevention choice for women at substantial risk of HIV infection as part of combination prevention approaches. The ring is made of silicone and is easy to bend and insert as it works by releasing the antiretroviral drug dapivirine from the ring into the vagina slowly over 28 days,” read a WHO statement.
“The DPV-VR is intended to reduce the risk of acquiring HIV during vaginal sex for women who are at substantial HIV risk as a complementary prevention approach in addition to other safer sex practices.”
The ring can also be offered alongside oral PrEP as a choice for women who do not want or are unable to take a daily oral tablet.
Research is also under way to develop a vaginal ring that includes both contraception and HIV prevention.
“Since November 2020, the DPV-VR has been included on the WHO’s pre-qualification list of medicines. This followed the positive scientific opinion from the European Medicines Agency (Ema) under Article 58 on the use of the DPV-VR for HIV prevention, which was granted in July 2020.”
The WHO Guideline Development Group assessed that the benefits of the DPV-VR outweigh the harms based on a systematic review and meta-analysis of the scientific evidence presented to them.
“This evidence included the cost–effectiveness of the dapivirine vaginal ring, acceptability, demonstrated feasibility, and the potential to increase equity as an additional prevention choice, noting some variability in effectiveness in younger age groups and limited data regarding use among pregnant and breastfeeding women,” read the statement.
The organisation said when providing HIV prevention services for women, it is important to provide them alongside other services.
“These include the offer of other HIV prevention choices, STI diagnosis and treatment, the offer of voluntary partner services, HIV testing and links to antiretroviral therapy for all women who test positive, and a range of contraception options. Services must also be provided for women who experience intimate partner violence and health care workers need training to provide services that are respectful and inclusive of women in all their diversity.” — @thamamoe.
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