A simple white ring could be a new, powerful weapon in the fight against the planet’s HIV epidemic.
Called a dapivirine ring, the device was unveiled Monday at the 2016 International AIDS Conference in Durban, South Africa.
Previously, two separate clinical trials showed the dapivirine ring to reduce the risk of HIV infections by about a third. But a new analysis shows that the ring may reduce that risk by 56% in consistent users — that is, women who use the ring every month.
In women who use the ring the most, the study suggested the device might reduce new infection risk by 75% or more.
It’s not foolproof, but it could change the face of the disease. At least 36.7 million people worldwide are infected with HIV, the virus that causes AIDS. Since 2000, HIV and AIDS have killed over 25 million people, and the infection remains the leading cause of death for women age 15 to 44 years old.
The dapivirine ring is about 2 inches across and impregnated with medication, similar to the kinds of plastic rings that deliver hormonal birth control (like the Nuva Ring). The ring is designed to release the antiretroviral drug dapivirine for 30 days at a time — after that, women are supposed to switch it out for a new one.
The device was developed by the International Partnership for Microbicides (IPM), a nonprofit devoted to the prevention of HIV infections in women.
How it works
Antiretroviral therapy refers to a combination of medications designed to keep HIV from multiplying and attacking the patient’s immune system. The drugs have been used to treat HIV infections since the 1990s, but recently doctors have also been using them to help prevent new infections in at-risk populations.
In the US, the best example of this is the pill Truvada, the daily HIV pre-exposure prophylaxis (PrEP) treatment that the FDA approved in 2012. Most PrEP users in the US are men who have sex with men. Though not often prescribed to people who inject drugs — the other group that still contracts HIV in significant numbers — PrEP has been shown to be somewhat effective among this last group.
In sub-Saharan Africa, the populations at risk for HIV/AIDS is much different — and the situation more dire. The region is home to 24.7 million people living with HIV and sees 1.1 million deaths AIDS-related deaths every year.
The face of the virus there is also increasingly young and female. According to the AIDS-prevention charity AVERT, more than 4 in 10 new infections in the region are young women between the ages of 15 and 24.
Young women are especially vulnerable because women’s rights are in a poor state in many places in sub-Saharan Africa. Women and girls who live there typically have little say in their sexual destinies, whether it’s in the context of sexual assault, forced marriage, or sex trafficking. Condom use is also staggeringly low, and intimate partner violence is commonplace.
So, an effective device that women can use discreetly to prevent HIV could be ground-breaking, provided women have access to the ring — a huge issue when it comes to any medical advancement.
IPM, which developed the ring, said in a press release that it has an exclusive worldwide licenses and will work “to ensure that women in low-resource settings have affordable access” to this and other dapivirine-based methods.
The organisation and its partners plan to continue ongoing clinical trials, as well as begin testing a 90-day ring. The makers are hoping that once potential users are convinced of the ring’s safety and efficacy, use will become widespread and consistent.
Right now, the world is at a turning point in the fight against AIDS. For years, the number of new infections declined steadily, but either stagnated or increased in the last five years — in Eastern Europe and Central Asia, new infections shot up 57%.
In 2014, roughly 2 million people became infected with HIV. If the United Nations wants to follow through on its pledge to cut new infections in adults to 500,000 by 2020, this ring — simple, affordable solution that women can implement unilaterally — could be the first step to ending a global epidemic.
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