JANUARY-FEBRUARY , 2022 | THE HEALTH

BY AMELIA HARNISH

One out of every five new HIV infections in sub-Saharan Africa occurs among adolescent girls and young women , despite this group representing just 10 per cent of the population . In some African countries , 80 per cent of new adolescent HIV infections are among girls .

This World AIDS Day , there ’ s at least one sign of hope on the horizon for changing those numbers : a novel long-acting HIV prevention product called the dapivirine ring .

We need to have options available that allow women to best protect themselves . The dapivirine vaginal ring is something they can control .

Developed by the non-profit International Partnership for Microbicides ( IPM ), the ring is designed to release dapivirine — an antiretroviral ( ARV ) drug that helps prevent HIV from replicating inside cells — into the vagina .

IPM received the rights to develop dapivirine as a vaginal microbicide through a worldwide license from the Janssen Pharmaceutical Companies of Johnson & Johnson and Johnson & Johnson Global Public Health , which is also partnering closely with IPM to plan for the ring ’ s introduction to the world . This licence is designed to ensure that women in low-resource settings have affordable access to any dapivirine-based vaginal HIV prevention method .

“ We need to have options available that allow women to best protect themselves ,” says Zeda Rosenberg , ScD , IPM ’ s founder and CEO .“ The dapivirine vaginal ring is something they can control ”— putting the power to prevent HIV in their hands .

For one thing , the ring is discreet . HIV prevention pills , Rosenberg explains , can be stigmatised in these countries because they can be misconstrued as HIV treatment . The ring also offers an alternative for women who are unable to take a pill every day or who simply don ’ t want to take a drug that works systemically — that is , throughout the body — because of the potential for greater side effects , she adds .

Here ’ s an inside look at how it works :

1 . The dapivirine ring is made of a flexible silicone matrix that ’ s comfortable to insert and generally isn ’ t felt once in place . It was modeled after a vaginal hormone replacement therapy ring called femRing , which releases estrogen to relieve menopause symptoms . Unlike some vaginal contraceptive rings , the dapivirine ring does not require refrigeration to store and has a five-year shelf life .

2 . The ring slowly releases a steady dose of dapivirine for 28 days . “ Women insert it for one month at a time , then

remove it and replace it with a new ring ,” Rosenberg explains . A version of the ring that can be left in place for three months is currently in clinical trials .

3 . “ Because the ring releases dapivirine locally into the vaginal tissue , relatively low amounts of the drug are absorbed into the blood system ,” Rosenberg says . The benefits of this method of administration ? Low potential for side effects , compared to other modes of drug administration . Already approved for use in Zimbabwe , the dapivirine ring — which has already received a positive scientific opinion from the European Medicines Agency and a recommendation from the World Health Organisation — is expected to roll out throughout 2022 in some countries in Eastern and Southern Africa , where the need for new HIV prevention tools for women is greatest . — The Health

This article appeared recently on the website of Johnson & Johnson

Why this innovation is so novel — and necessary There are already daily ARV pills on the market that help prevent HIV , and a potential preventive injectable therapy is currently under review by the US Food and Drug Administration . But “ the ring fills a gap in options ,” Rosenberg says , especially for women in African countries who continue to face an alarmingly high HIV risk and may have less sexual autonomy than women in other parts of the world .