Dapivirine ring offer hope for HIV prevention efforts in Malawi

Martha Chikoti

For a long time, some myths and beliefs around HIV and AIDS prevention methods like condom use and Pre-Exposure Prophylaxis (PrEP), have put a lot of women at risk of contracting the virus.

But, there is hope to encourage more women to use prevention methods. With the introduction of Dapivirine vaginal (DPV-VR) ring, not yet on the market – shows more women will be able to use it to protect themselves from HIV and AIDS.

The DPV-VR a silicone ring designed to provide women with a discreet and long-acting option for HIV prevention as it contains the anti-retroviral drug called Dapivirine, which is released slowly to reduce the risk of HIV infection.

Executive Director of Generational Empowerment Movement (GEM), Ulanda Mtamba said once the DPV-VR is embraced, it will help a lot of women and girls.

“There is a need to bring awareness on the methods that are used as a way of prevention of HIV and AIDS, which includes the Dapivirine ring, so that those in rural areas should be aware and accept it at an early stage.”, Mtamba added

Resounding the significance of the initiative, Southern Africa Trust (SAT) Country Director, Robert Mangwazu Phiri, underscored that DPV-VR has potential and is effective in addressing women’s sexual health needs in Malawi.

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.

It can be offered alongside oral PrEP as a choice for women who do not want or are unable to take a daily oral tablet.

HIV prevention advocate, Maureen Luba, said that with 91 percent of people who are aware of their status on HIV treatment, Malawi is beginning to show progress on the way to ending the epidemic.

“The Dapivirine ring is a significant addition to our HIV prevention toolkit” says Luba

The World Health Organization (WHO) recommended that 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 DPV-VR is a female-initiated option to reduce the risk of HIV infection. To properly use the ring, it must be worn inside the vagina for a period of 28 days, after which it should be replaced by a new ring.

The ring is made of silicone and is easy to bend and insert. The ring works by releasing the antiretroviral drug Dapivirine from the ring into the vagina slowly over 28 days.

Two Phase III randomized controlled trials found that using the DPV-VR reduced the risk of HIV infection in women and long-term use was well-tolerated. The Ring Study demonstrated an HIV reduction of 35% among women using DPV-VR, and the ASPIRE study a 27% reduction in risk.

Results from the open-label extension studies of the trials showed increases in ring use and modeling data suggest greater risk reduction — by over 50% across both studies — compared to the Phase III trials.

Secondary analyses of the trial data also suggest higher risk reduction among women who consistently used the DPV-VR.

While contraceptive vaginal rings have been available for several years, the DPV-VR is the first vaginal HIV prevention product. Research is under way to develop a vaginal ring that includes both contraception and HIV prevention.