Paidamoyo Chipunza recently in Durban, South Africa
New exploratory data from a study done to ascertain the effectiveness of a vaginal ring in preventing HIV infection in women has shown that its monthly use could actually reduce the risk of contracting HIV by up to 75 percent, delegates attending the 21st International Conference on Aids underway in Durban heard on Thursday. Initial results from the study commonly referred to as ASPIRE (A Study to Prevent Infection with a Ring for External Use) had shown that the ring had up to 31 percent chances of reducing HIV infection if used consistently.

Developed by the International Partnership for Microbicides (IPM), the ring contained the antiretroviral drug called dapivirine. It is then placed high inside a woman’s private parts where it steadily releases the medication over the course of the month. Women insert the ring and remove it on their own.

In a statement, the study’s principal investigator from the Microbicide Trials Network, Professor Elizabeth Brown, said further analysis into the results was necessitated by the fact some women who took part in the study were not using the ring at all.

She said this precipitated the move to further analyse data which came from those women who used the ring consistently and noted that the ring actually had chances of reducing HIV by up to 75 percent if used regularly.

“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.

“Across all analyses, we saw high adherence was associated with significantly better HIV protection,” said Prof Brown. According to researchers, they determined how consistently the women used the ring by testing levels of dapivirine in their blood every three months. They also tested how much drug remained on 12 000 rings the women used.

The researchers classified the women based on how regularly they used the ring, ranging from non-use to almost perfect use. They found that women who appeared to use the ring most regularly from month to month could cut their HIV risk by at least 50 percent and up to 75 percent or more in some cases.

According to the researchers, there was therefore need for more confirmatory studies to reinforce these new developments and a new study, known as HOPE, is one such example.

ASPIRE protocol chairman and leader of the HOPE study Dr Jared Baeten said HOPE will explore why the ring may work well for some women but not others.

“The goal of HOPE is to offer women a product shown to be safe and able to provide some protection against HIV. When we were conducting ASPIRE, we did not know whether the ring would be effective. Knowing the results of ASPIRE, it will be a totally new conversation with women in HOPE,” said Dr Baeten.

The ASPIRE study was conducted in Zimbabwe and other African countries between 2012 and 2015. More than 2 600 African women between the ages of 18 and 45 from Malawi, South Africa, Uganda and Zimbabwe took part in the study. In Zimbabwe, the study took place in Chitungwiza and at Spilhaus Clinic in Harare.

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