WOMEN who inserted a vaginal ring coated with an anti-Acquired Immune Deficiency Syndrome (AIDS) drug once a month were partially protected against Human Immuno-deficiency Virus (HIV) infection, scientists have revealed.
On Monday researchers released long-awaited results from two large studies in Africa.
These showed the ring proved safe although the protection was modest, reducing overall HIV infection by less than a third.
The large study was carried out in Malawi, South Africa, Uganda and Zimbabwe, and published in the New England Journal of Medicine.
Surprisingly, the ring worked far better in women 25 and older, leaving researchers wondering if the youngest women, who got little to no benefit, simply didn’t use the device properly.
Women make up more than half of the nearly 37 million people worldwide living with HIV, most of them in hard-hit Africa, and scientists have long sought tools to help them protect themselves when their partners won’t use a condom.
Despite questions the studies raise, the nonprofit International Partnership for Microbicides (IPM) said it considered the results promising enough to seek appropriate regulatory approval for wider use in parts of Africa.
Founding chief executive officer of IPM, Dr. Zeda Rosenberg, said: “You can’t just say. Until something is perfect, we’re going to wait. We have to give women options.”
Dr. Jared Baeten of the University of Washington, who led a study funded by the National Institutes of Health (NIH) on the ring said: “For a woman to have a prevention tool that she can control is an incredibly important goal,’ added.
“I want rings, pills and other strategies to be on the shelf for women so they can make choices for what’s going to work for them.”
Aside from condoms, HIV prevention tools include taking a daily anti-AIDS pill.
However, so-called ‘pre-exposure prophylaxis’ isn’t widely available in poor countries, and other attempts at HIV-blocking vaginal gels haven’t yet panned out.
But the age disparity found in the vaginal ring studies is so puzzling that the NIH plans to consult with outside experts on next research steps.
While women need a discreet form of HIV prevention, it’s critical to determine if the younger women really didn’t follow instructions, or if there was some biological difference, said Dr. Anthony Fauci, director of United States National Institute for Health (NIH’s) National Institute for Allergy and Infectious Diseases.
Vaginal rings are sold in the United States (U.S.) and United Kingdom (U.K.) for birth control, but the anti-AIDS version tested in Africa contained no contraception.
Instead, it slowly oozes an experimental virus-blocking drug named dapivirine into the surrounding vaginal tissue. Women would replace the ring once a month, when it was time for another dose.
Two studies involving more than 4,500 women in Africa are being presented at the Retrovirus Conference in Boston, comparing women who used the dapivirine ring with those given an identical-looking but drug-free version.
It offered modest protection, reducing the risk of HIV by 27 per cent so the new overall risk of contracting the virus is 31 per cent.
But closer inspection of the large study, which was carried out in Malawi, South Africa, Uganda and Zimbabwe, and published in the New England Journal of Medicine, revealed an odd finding.
Ring users who were 25 and older were 61 per cent less likely to be infected while those ages 18 to 21 essentially got no benefit, Baeten said.
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