- On Monday, the National Institutes of Health revealed the results of a 2014 multinational trial which found that a vaginal ring that releases an antiretroviral drug provided some protection against HIV infection in women.
- The ring reduced the risk of infection by 27% among all of the study participants, and by 61% among women 25 years and older.
- The results of the NIH-funded study, published in the New England Journal of Medicine, were similar to those of another clinical trial, which found the ring had an effectiveness of 31%.
The clinical trial, called ASPIRE -- A Study to Prevent Infection with a Ring for Extended Use -- was conducted in four sub-Saharan African countries in which women accounted for more than half of the 25.8 million people with HIV. One in four new HIV infections in sub-Saharan Africa occur among adolescent girls and young women.
“Women need a discreet, long-acting form of HIV prevention that they control and want to use,” said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), the part of the NIH that primarily funded the trial. “Further research is needed to understand the age-related disparities in the observed level of protection,” Fauci said in a prepared statement.
The study, which enrolled more than 2,600 HIV-uninfected women who are at high risk of contracting the infection, ran from 2012 to 2014 with the goal of exploring the possibility of using the antiretroviral drug dapivirine to "safely and effectively prevent HIV infection when continously released in the vagina from a silicone ring replaced once every four weeks."
Although the dapivirine ring was effective in providing partial protection to some women who were 25 years and older, it did not provide women younger than 25 with significant protection who used the ring less consistently than other participants.
“The ASPIRE study is the first to demonstrate that a sustained drug delivery product that slowly releases an antiretroviral drug over time can offer partial protection from HIV,” said co-leader of the study Thesla Palanee-Phillips, director of network trials and research center programs at the Wits Reproductive Health and HIV Institute in South Africa.
A separate multinational clinical trial called The Ring Study, conducted by IPM, found the dapivirine ring had an overall effectiveness of 31%, with women older than 21 years experiencing a slightly greater risk reduction of HIV infection.