The HIV vaginal ring is a silicone elastomer vaginal matrix ring that dispenses an anti-HIV drug when in use. This causes the wearer to be protected from the HIV infection for a month. It is flexible and affordable, not more than $5 per ring. After it is worn, it slowly releases an antiviral drug called Dapivirine (a highly potent ARV drug known as a non-nucleoside reverse transcriptase inhibitor, it works by preventing HIV from replicating its genetic material after the virus enters a healthy cell). Alternately, the ring is referred to as the Dapivirine ring. It was developed by the International Partnership for Microbicides (IPM).
The incurable HIV/AIDS pandemic is something that not only resonates with the African continent, it does with the rest of the world. The emergence of the vaginal ring however is the world’s own little way of saying ‘we fight back’. Although the ring’s success rate was fully determined in 2016, since 2012, the IPM has been dedicated to making use of their scientific resources to develop a resistance to the disease, after all, various scientists around the world have undertaken unsuccessful measures towards getting a cure to no avail.
The vaginal ring has less than 50 percent guarantee to be free from HIV infections. According to the Scientific American, the data presented at the recently concluded Conference on Retroviruses and Opportunistic Infections in Boston, USA, showed that the women who used the ring were 27 percent less likely to become infected with the HIV virus.
In testing the efficiency of the vaginal ring, Africans were used for clinical trials referred to as ‘A Study to Prevent Infection with a Ring for Extended use’ (ASPIRE) due to the fact that several countries on the continent have the highest number of persons living with HIV/AIDS, many of whom are women. The countries where the trials were set up are South Africa, Malawi, Uganda and Zimbabwe.
As at June 2015, ASPIRE had already begun testing several women in these countries. After insertion of the vaginal ring, the user was expected to participate in monthly clinic appointments. During said appointments, participants received tests for HIV and sexually transmitted infections (STIs), adherence counselling, were given condoms and safer sex advice and had blood samples drawn to determine adherence levels (these were anonymized and only looked at after the active phase of the trial). Participants were followed-up for a month after last ring use to look at whether the HIV infection rate increased when use stopped.
During trial, it was discovered that efficacy of the vaginal ring was 61 percent effective in women 25 years of age and older but it was only 10 percent effective in women younger than 25 years of age. Also, it was discovered that for full benefits to the user, the ring will have to be worn consistently for an entire month before it is removed (although it can be re-inserted), if it is removed sooner, the ring may not work as effectively. Aside from a high rate of HIV/AIDS infection, the following statistics provide an insight to HIV realities in South Africa, Malawi, Uganda and Zimbabwe.
According to Statistics South Africa in 2015 mid-year estimates on HIV/AIDS, the estimated overall HIV prevalence rate is approximately 11.2 percent of the total South African population. The total number of people living with HIV is estimated at approximately 6.19 million in 2015. For adults aged 15–49 years, an estimated 16.6 percent of the population is HIV positive.
According to a 2015 Malawi narrative report, it is estimated that 1.1 million Malawians were living with HIV in 2014 and that 34,000 new infections occurred in 2014, including 7,400 amongst children aged less than 14 years.
Reuters reports that about 1.5 million people, or about 4 percent of the population, live with the HIV virus, and about 820,000 receive anti-retroviral (ARV) drugs, which help keep the patient’s viral load low and prevent transmission.