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The Dapivirine Ring Expanding Women's Choices for HIV Prevention

Today is a milestone for women’s HIV prevention.

As a woman-controlled HIV prevention method, the dapivirine ring could expand women’s choices where new interventions are urgently needed.

Today’s positive opinion from the European Medicines Agency for the ring’s use by cisgender women ages 18 and older in developing countries opens the door to regulatory submissions in sub-Saharan Africa, where women face alarmingly high risk for HIV.

The dapivirine ring could fill a critical gap with a long-acting option that a woman could use privately, on her own terms.

Existing HIV prevention products like condoms and daily oral pills (called PrEP) are highly effective when used as directed and are essential parts of the HIV prevention toolkit. But not all women can control or negotiate for condom use, and some women face challenges taking a daily pill.

No one product is right for all women, and women’s needs change over the course of their lives.

That’s why more options are needed—so women can choose the highest efficacy product that they can use consistently.

The International Partnership for Microbicides (IPM), a nonprofit organization, developed the dapivirine ring to address this need.

The ring is made of a flexible silicone and contains an ARV drug called dapivirine that is slowly released locally in the vagina over the course of a month. Women would insert and replace the ring themselves each month—set it and forget it.

Phase III data show the ring reduced HIV risk by 35% overall with no safety concerns. Encouragingly, subsequent open-label studies suggested higher overall efficacy—by about half.

Phase III data also show lower risk reduction in women 18-21 due to low product use. Additional planned research will help us better understand the ring’s use and efficacy among young women.

For women who cannot or choose not to use higher efficacy products like daily oral PrEP, a monthly product like the ring could give them a way to reduce their HIV risk.

Offering women multiple methods like the monthly ring and daily oral PrEP is vital to controlling the epidemic and to ensuring their sexual & reproductive health & rights. Linda-Gail Bekker

We couldn’t have done this alone.

IPM’s partners around the world were critical to today’s achievement. Thank you to all the women who participated in ring studies, community members and civil society advocates, researchers, governments, donors, and the Janssen Pharmaceutical Companies of Johnson & Johnson, which granted IPM the rights to dapivirine. We are grateful to collaborate with partners who share our vision of empowering women with new HIV prevention options they can use on their own terms to protect their sexual and reproductive health.

Today’s opinion is an exciting step. But the journey doesn't stop here.

It will require a collective effort to get the ring approved and into the hands of women in sub-Saharan Africa, where women have an unmet and urgent need for new HIV prevention tools.

We continue to study how the ring could meet women's needs at different points in their lives. Research led by IPM's partner, the Microbicide Trials Network, is assessing the monthly ring’s safety and use among adolescent girls and young women, and pregnant and breastfeeding women. And we're excited about longer-acting rings IPM is developing, including a three-month dapivirine ring and a three-month ring to provide HIV prevention and contraception.

The future may bring other promising new HIV prevention tools. Products being developed include multipurpose technologies, long-acting injectables, vaccines, rectal microbicides and more.

All these methods will be needed to bring the epidemic under control.

As we celebrate today’s news about the monthly dapivirine ring with our partners, we are as optimistic about women’s HIV prevention, and our mission, as we have ever been.

Credits:

International Partnership for Microbicides