Vaginal ring helps protect women against HIV

A vaginal ring containing an antiretroviral drug called dapivirine is safe and helped protect against HIV in a large-scale clinical trial involving more than 2,600 women in Zimbabwe, Malawi, Uganda and South Africa.

The trial, known as ASPIRE, was led by the National Institutes of Health-funded Microbicide Trials Network. It enrolled HIV-negative women ages 18 to 45. In Zimbabwe, the study was led by Dr Z. Mike Chirenje of the Bixby Center’s University of Zimbabwe-UCSF Collaborative Research Programme. 678 women took part in the study across three clinical research sites.

The study found the dapivirine ring reduced the risk of HIV infection by 27 percent overall. Women in the study inserted the ring into their genital tract and used it for a month at a time.

The risk of HIV was reduced significantly more among the study’s older participants, who also used the ring most consistently. Researchers initially found that women in the dapivirine group who were 25 and older were 60 percent less likely to acquire HIV than women of the same age in the placebo group. To explore this age-related effect further, investigators performed analyses that were not originally planned and found that the ring reduced the risk of HIV infection by 56 percent in women older than 21 years, but provided no protection for women ages 18 to 21 years. More research is needed to determine whether behavior, biology or a combination of factors contributed to the lack of significant protection for younger women.

Results of the ASPIRE study were announced at the Conference on Retroviruses and Opportunistic Infections (CROI) in Boston. ASPIRE results were also published online in the New England Journal of Medicine (NEJM).

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