The ASPIRE study showed that the dapivirine ring reduced HIV infection risk by up to 27 percent and 61 percent among older women, ages 25 years and older, during an announcement at the Conference on Retroviruses and Opportunistic Infections (CROI) in Boston on Jan. 22. The ring is inserted in the vagina, where it slowly releases the experimental antiretroviral drug, dapivirine, providing partial protection from HIV.
The findings of the ASPIRE study or the MTN-020 have been published online in the New England Journal of Medicine. The researchers enrolled 2,600 non-infected high-risk women, ages 18 to 45 years, from Malawi, South Africa, Uganda, and Zimbabwe in 2012. The women received either the dapivirine ring or a placebo ring randomly.
The participants were given HIV counselling, HIV testing, free condoms and sexually transmitted infection treatments. The research team observed that the participants were 27 percent less likely to acquire HIV and women who were 25 years and older had a 61 percent less chances of acquiring HIV. However, the researchers noted that the older women used the ring more consistently than the younger ones.
“To help bring about an end to the HIV/AIDS epidemic, women–especially those in sub-Saharan Africa–need multiple options for HIV prevention,” adds researcher Jared Baeten, a professor of global health, medicine and epidemiology at the University of Washington in Seattle. “The ASPIRE study was an important step towards determining whether the dapivirine ring could become one such option.”
“Women need a discreet, long-acting form of HIV prevention that they control and want to use,” says Anthony Fauci, the primary funder of the study and the director of the National Institute of Allergy and Infectious Diseases (NIAID). “This study found that a vaginal ring containing a sustained-release antiretroviral drug confers partial protection against HIV among women in sub-Saharan Africa.”
According to the researchers, half of the 25.8 million people with HIV diagnosed in 2014 in sub-Saharan Africa were women. The say that more research is needed to understand the age-related disparities. NIAID’s next step is to consult with outside experts to further the dapivirine ring study.