Study suggests young women prefer vaginal ring over oral PrEP for HIV prevention
Click Here to Manage Email Alerts
Adolescent girls and young women preferred the dapivirine ring over oral PrEP for HIV prevention by a two to one margin in a study conducted in three African countries, researchers reported Tuesday.
“Ensuring that young women and girls can have access to a range of safe and effective HIV prevention methods is vitally important, because as has been seen with contraceptives, the more options that are available, the more likely there will be one that can and will be used,” Kenneth Ngure, PhD, MPH, MSc, a behavioral scientist in HIV prevention and chairman of the department of community health at Jomo Kenyatta University of Agriculture and Technology in Kenya, told Healio.
“Daily oral PrEP is approved in many countries, but it’s only one method, and for many adolescent girls and young women, it’s not a method they find easy or desirable to use,” Ngure said.
Over the past 2 years, WHO has prequalified the dapivirine ring and recommended its use among women at substantial risk for HIV. The ring, which must be worn inside the vagina for 28 days and then replaced, has demonstrated modest effectiveness in trials.
Ngure and colleagues assessed preference and adherence to the dapivirine ring and oral PrEP among 247 adolescent girls and young women aged 16 to 21 years from South Africa, Zimbabwe and Uganda who were enrolled in the REACH crossover trial and were not infected with HIV and not pregnant. The REACH trial previously demonstrated higher rates of adherence to oral PrEP and the vaginal ring.
In the study, participants were randomly assigned to either the ring or daily oral tenofovir disoproxil fumarate/emtricitabine for the first 6 months before switching to the other product for the next 6 months. After that, participants were asked to choose one or the other — or neither — to use for another 6 months.
Among the participants, 227 (92%) continued through the third period of the study 152 (67%) of them chose the dapivirine ring, 71 (31%) oral PrEP and four (2%) neither.
According to Ngure and colleagues, residual dapivirine levels in used rings and tenofovir diphosphate levels in dried blood spots indicated high use of the ring and moderate to high adherence to oral PrEP, with less than 5% of visits involving no adherence.
High adherence to oral PrEP in the crossover period was strongly associated with choosing oral PrEP (P < .001) in the last period, although a similar association was not observed for dapivirine rings (P = .85).
“As we have seen with contraceptives, providing adolescent girls and young women with HIV prevention options and allowing them to make their own decisions about what’s right for them can make a difference,” Ngure said. “Importantly, results indicate that the monthly dapivirine ring could be a viable option for those who don’t want to or choose not to use oral PrEP.”
Collapse
Ngure K, et al. LB 88. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 12-16, 2022 (virtual meeting).
Read more about
Click Here to Manage Email Alerts