A vaginal ring containing antiretroviral drugs is safe and acceptable for HIV prevention among adolescent girls, a study has shown.
The vaginal rings are flexible and fit high up around the cervix, where they release the medication gradually over time.
However, the device does not prevent pregnancy. The ring is a relief to women in discordant relationships as well as those seeking to conceive.
The findings were presented at the 9th International Aids Society Conference on HIV Science in Paris recently.
This study marks the first time the vaginal ring was tested in adolescent girls younger than 18 years.
“Adolescents and young people represent a growing share of people living with HIV worldwide,” says Anthony Fauci, director at National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.
“Science has demonstrated that the HIV prevention needs of adolescents may be different than those of adults, which is why these new study findings are so important.”
Adolescent girls and women aged between 15 to 24 are at particularly at risk of contracting HIV. “Using the ring most or all of the time reduced the risk of HIV infection in the group by at least 56 per cent,” says Dr Fauci.
The young women accounted for 20 per cent of new HIV infections among adults globally in 2015, despite comprising only 11 per cent of the adult population.
The ring had been previously tested in 4,588 women aged between 15 to 45 in four African countries — Malawi, Uganda, South Africa and Zimbabwe — where HIV rates among women are one of the highest globally.
When used consistently for a month, the ring keeps the virus that is carried by nearly 1.8 million Kenyans at bay.
The ring, which a woman can insert and remove by herself, was also found to be safe to use in all stages of a woman’s life even if she is lactating.
“Among the women who appeared to use the ring regularly, HIV risk was cut by more than half across all analyses and in some by 75 per cent and others even more,” says Dr Elizabeth Brown from the Fred Hutchinson Cancer Research Centre.
A Higher level of protection was seen among those who used the ring regularly. The HIV risk was reduced by about one third, which means that one in three women who might have acquired HIV did not.
Even though the ring used among the adolescents is still under trials, the one which was tested on women aged between 15-45 is on sale for Sh500-Sh1,000.
The researchers urged the developers roll out the anti-HIV ring in as many countries as soon as possible.
Dr Fauci says the tests would be conducted in Kenya next, given that most of the young women and adolescent girls have recorded high new HIV infections, especially among the teenagers.
According to the National Aids Control Council, there were more than 61,000 new HIV infections last year, with the majority being youth aged 15 and 24.
The agency cited challenges in curbing new infections.
Of the new cases, 13,700 were adolescents aged between 10 to 19, accounting for 22 per cent of all new infections. Some 26,000 of the new infections were among those aged between 15 to 24, accounting for nearly half (43 per cent) of the new cases.
The vaginal ring study enrolled 96 girls in the United States. Sites were assigned at random to receive either the dapivirine ring or a placebo ring in a three-to-one ratio.
The study examined the safety and acceptability of the ring among sexually active girls aged 15-24.
“Neither the participants nor the investigators knew who had received which ring until the end of the trial.
“Participants were asked to insert a new ring each month for six months. Researchers monitored participants’ health and gauged adherence by measuring the amount of dapivirine in blood samples and used rings,” says Dr Fauci.
Investigators found that the dapivirine ring was safe and acceptable to study participants. Adherence to the ring was high and drug levels in 87 per cent of blood samples and 95 per cent of used rings met pre-specified adherence criteria.