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Study of new vaginal ring intended to stop both HIV and pregnancy

HIV positive Monica and her granddaughter. (Credit: UNICEF)

(Editor’s note: This is a safety trial that does not test for effectiveness. An earlier version of the story incorrectly said this trial included efficacy testing.)

A vaginal ring that is designed to prevent both HIV and pregnancy – two of the greatest threats to women’s health – will be tested on women to see whether the novel, long-term dual-protection approach is safe and shows proper biological activity.

The nonprofit International Partnership for Microbicides (IPM) announced on Wednesday the launch of a clinical trial aimed at determining the safety and pharmokinetics (metabolism, absorption) of a three-month vaginal ring that releases the antiretroviral drug dapivirine to prevent HIV as well as the contraceptive hormone levonorgestrel. The IPM is already testing a shorter-term ring that protects against HIV for effectiveness.

Zeda Rosenberg, founder and chief executive officer of IPM, said the only other effective products that offer this type of dual protection against HIV and unwanted pregnancy are condoms.

“Condoms are not practical options for many women,” Rosenberg told Humanosphere. “Given that the drop in new HIV infections has stalled and that 225 million women have an unmet need for contraceptives, we know that women need more options to protect their sexual and reproductive health.”

Numerous IPM studies have documented women’s high interest in and willingness to use vaginal rings. According to Rosenberg, many women prefer a longer-lasting, discreet alternative to condoms because they lack agency in their sexual lives and are unable to negotiate condom use with male partners.

Still, an estimated 225 million women of reproductive age in developing countries lack access to any form of contraception, according to the World Health Organization. Experts say lack of family planning can lead to a host of public health issues, among them higher rates of abortion (especially unsafe abortion); pregnancy-related health risks in women and infant mortality; fewer opportunities to pursue education and participate in public life; and poor social and health outcomes for children.

Regions with the highest unmet needs for contraception are also often in most desperate need of HIV prevention, according to IPM. This presents an additional burden on women, who carry nearly 60 percent of the HIV burden in sub-Saharan Africa. Girls and women between the ages of 15 and 24 face an especially high risk of unknowingly contracting the virus.

With the number of new HIV infections rising in 74 countries, health experts say it is more important now than ever to come up with more effective HIV prevention strategies that women in high-risk areas will actually use.

“Young women are facing a triple threat,” UNAIDS Executive Director Michel Sidibé said in a statement last year. “They are at high risk of HIV infection, have low rates of HIV testing and have poor adherence to treatment. The world is failing young women and we urgently need to do more.”

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About Author

Lisa Nikolau

Lisa Nikolau is a Madrid-based reporter for Humanosphere, covering gender equality, indigenous rights and poverty in Latin America and worldwide. Find her on Twitter at @lisanikolau, email lisa.nikolau@humanosphere.org or see her latest work at www.lisanikolau.com