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Monday, April 18, 2016

10 'Interesting' questions About the Dapivirine Vaginal Ring:


By Esther Nakkazi

On 22 February this year, news of two trials of HIV prevention for women was released at the 2016 CROIC Conference. A big thank you to the researchers and the 2,629 women at 15 sites in Malawi, South Africa, Uganda and Zimbabwe who enrolled in the ASPIRE study led by the Microbicide Trials Network

Another big thanks to the 1,959 women at 7 sites in South Africa and Uganda who participated in the Ring Study, led by the International Partnership for Microbicides and of course the scientists. They added another tool for HIV prevention that can be used by women.

In both studies, the ASPIRE and The Ring Study some women used the ring with dapivirine, a first long-acting ARV-based product while others used a placebo. These were Phase III trials designed to evaluate whether the dapivirine ring is safe and effective when used for one month at a time. Both studies found evidence of modest protection.

Women over 21 years of age appeared also to use the ring most consistently. The ring was not effective in women ages 18 to 21 years, who also had the lowest adherence.

Since they released news about these studies, I have attended many forums discussing the vaginal ring results, worth mentioning is our own science cafe organised by the Health Journalists Network in Uganda. It was the 11th we ever held and generated the biggest media coverage and buzz.

For the forums I have attended pertaining to this new innovation here are some of damn absurd questions that I have heard being posed to scientists:

  1. Can’t the vaginal ring get stuck in the fallopian tubes?
  2. Will the ring be a ‘one size fits all’? (The concern was that some penises are bigger than others and will not pass through the ring?)
  3. Will the dosage in the ring be effective for people who have multiple sex acts? Won’t the dapivirine reduce and not last for the one month it is intended for?
  4. If you wash the vagina frequently won’t it affect the medicine (dapivirine) in the ring? 
  5. Does douching affect the ring? 
  6. How long does the ring start working after inserting it?
  7. Won’t the vaginal ring get stuck on the penis during sex?
  8. Doesn't the dapivirine vaginal ring make women infertile?
  9. Can the ring be used by lesbians?
  10. For the ring not to work among below 21 year olds is it only because of adherence or for another reason like the age of the vagina?
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