Preventing HIV infection with dapivirine vaginal ring

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Preventing HIV infection with dapivirine vaginal ring
Preventing HIV infection with dapivirine vaginal ring

Africa-Press – Malawi. A 26-year-old Malita [not her real name] was gang-raped by three men at Lizulu Market in area 4 in Lilongwe on her way home from work. Malita was walking on a passage between Sana Mega Shop and the market when the men attacked, robbed and raped her.

“She was severely traumatized to the extent that she moved out of Lilongwe to her home village,” State Prosecutor Sub Inspector Bauleni Namasani, giving details in court.

This is how dangerous the environment is for women. Worse still, through such despicable ordeals, some women have contracted diseases such as HIV and Aids.

Statistics by the United Nations Programme on HIV and Aids (UNAIDS) show that more than one third (35 percent) of women around the world have experienced physical and/or sexual violence by an intimate partner or sexual violence by a non-partner at some time in their lives.

It is for such reasons that women need the Dapivirine Vaginal Ring (DVR). The ring, which is still under consideration by a number of African National Medicines Regulatory Authorities, including Malawi, has proven to reduce the risk of HIV infection among women at high risk.

Women insert the product and replace it every month. Made of flexible silicone, the ring slowly releases the antiretroviral (ARV) drug dapivirine in the vagina, with minimal absorption elsewhere in the body.

“With DVR, a woman will be able to reduce the risk of HIV infection without even seeking permission from her male partner and the male partner will not even notice that the woman is using the method,” says Linly Seyama, a community engagement and study coordinator at College of Medicine’s John Hopkins.

Statistics by UNAIDS show that every week, around 5000 young women aged 15–24 years become infected with HIV. In sub-Saharan Africa, six in seven new HIV infections among adolescents aged 15–19 years are among girls. Young women aged 15–24 years are twice as likely to be living with HIV than men.

For Malawi, the prevalence of HIV among adults ages 15 to 64 years is 10.6 percent: 12.8 percent among females and 8.2 percent among males. This corresponds to approximately 900,000 people living with HIV (PLHIV) ages 15 to 64 years in Malawi.

Malawi, which took part in the study, will be among the first countries to benefit. It is, therefore, exciting that researchers are making strides in the DVR study with the World Health Organisation (WHO) giving a prequalification for the ring for Women’s HIV Prevention.

It is also another step closer to the introduction of the ring, pending country approvals, and confirms that the new HIV prevention method meets global standards for quality, safety and efficacy.

Following the prequalification, the International Partnership for Microbicides (IPM) proceeded to submit dossiers to African National Medicines Regulatory Authorities (NMRAs) for their decisions.

“IPM as is required, submitted the dossier to a number of African country regulatory authorities including Malawi. This happened around February, 2021. Currently, the dossier is with the regulatory authority in Malawi, Pharmacy and Medicines Regulatory Authority-Malawi,” Explains Novice Bamusi, Country Program Officer for the Sexual Reproductive Health and Rights (SRHR) Africa Trust-SAT, IPM advocacy partner.

He says stakeholders are eagerly waiting for the outcome from Malawi regulatory authority and equally interested are would-be beneficiaries of the DVR who have been updated on the progress made towards making the DVR available.

According to Bamusi, once the regulatory authority has approved the DVR, the Ministry of Health will then develop guidelines on the usage of DVR. “This will be good news to the public in that there will be more options available to women to reduce the risk of HIV infection,” said Bamusi.

Dr. Zeda Rosenberg, founder and chief executive officer of IPM, which developed the dapivirine ring and is the product’s regulatory sponsor, says women want and deserve new choices in HIV prevention.

Apart from Malawi, other African countries to first benefit include Zambia, Zimbabwe, South Africa, Rwanda, Uganda, Kenya and Tanzania. “Our aim is to make the ring available first in sub-Saharan Africa, where women face persistently high HIV risk,” he adds.

Women bear a disproportionate burden of the global HIV/AIDS epidemic, with nearly 60 percent of new adult infections in sub-Saharan Africa occurring among women.

When locally approved, HIV-negative women who are at risk of HIV infection will be able to access the ring at an affordable price with existing health systems and structures as suppliers. Even when in unforeseeable circumstances such as that of Malita, women who wear the dapivirine ring will be able to reduce the risk of HIV infection.

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