Dapivirine Ring-another HIV prevention tool for women

By Lynette Manzini

The prospects of women in Sub Saharan Africa accessing a long acting HIV prevention tool that gives them control over their sexual health, increased last Friday after an independent scientific agency passed a positive opinion which has paved way for licensing the tool.

The European Medicine Agency (EMA) shared the positive developments almost two years after clinical trials testing the safety and adherence of women using the of the Dapivirine Vaginal Ring proved to reduce HIV infection by 40 percent in a trial known as the HOPE study  ( HIV Open label Prevention Extension ).

The clinical trials were conducted across 14 sites in Malawi, South Africa, Uganda and Zimbabwe with a total of 1456 African women participating in the study.

Made from a flexible silicone, the ring  is inserted in the vagina where  an antiretroviral drug Dapivirine is slowly released as protection against HIV infection right at the point of contact for 28 days. A woman can insert and remove the ring herself.

During an online meeting with health reporters, the Co Chair of the Hope study across the four countries participating African countries and the principal investigator in Zimbabwe Dr Nyaradzo Mgodi expressed her delight towards the positive opinion passed by EMA and highlighted the stringent process the research findings go through with EMA before they either get a positive or negative opinion.

“This a milestone which means that the ring is closer ever for women to access it.”

“The ring has been reviewed by experts who review medicines and has been approved for registration.”

“This is good news for women as we are towards the end of providing another tool for HIV prevention for women,” Dr Mgodi said.

The patriarchal nature of African societies have influenced the power dynamics in heterosexual sexual relationships striping  women of the ability to protect themselves from  HIV or Sexually Transmitted infections (STI).

A research conducted by Esther Mugweni in 2012  to identify barriers faced by married women when negotiating for safer sex revealed that women were voiceless to negotiate for safer sex as a result of lack of sexual decision-making power, economic dependence or fear of actual or perceived consequences of negotiating for safer sex such as intimate partner violence.

In an interview with Locally based HIV and AIDS advocate and journalist Anna Miti said the Dapivirine Ring will  empower previously disadvantaged heterosexual women who were in no position to negotiate safe sex with their partners before introduction of the HIV prevention tool. 

“The addition of a new woman controlled device is now a reality that we will see anytime soon.”

“As you know condoms, both male and female require male cooperation. Unfortunately for what we gather in communities not many men want to use condoms.”

“ Also condoms are not for everyone for instance someone who wants to fall pregnant and prevent HIV, in this case  the ring would work for them.”

“It also means apart from Prep, women can have something else to prevent HIV, “ Miti said.

A member of the Community Advisory Board (CAB) Beauty Nerupfunde from Chitungwiza added: ” I am very proud to have been part of the trial because sometimes trials do not produce the desired results but the HOPE study has been successful.”

” For a woman such as myself i feel very empowered because the dapivirine ring is something that is inserted in me and i am sure of protection for 28 days around the clock in case, in the event i encounter unsafe sex.”

“With this tool adherence is easy because the ring is inserted within me for the prescribed duration,” Nerupfunde added.

Zimbabwe has among one of the highest HIV prevalence with the majority of the cases. Unprotected heterosexual sex continues to be the main transmission route for new infections.