The vaginal ring: Researchers inching closer to HIV/AIDS prevention

Written By: Celestine Mwango/Prudence Wanza

Kenyan researchers are looking into the potential of the Vaginal Dapirivine ring, an antiretroviral drug,in prevention and treatment of HIV/AIDS.

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The researchers are also working on the Antibody Mediated Prevention (AMP) study which they believe could provide a breakthrough in treating HIV/AIDS.

Vaginal Dapivirine ring

The Vaginal Dapivirine ring is an antiretroviral drug called dapivirine. It’s released slowly over the course of one month directly to vaginal tissues to help protect against HIV at the site of potential infection. Little of the drug is absorbed elsewhere in the body resulting in low systemic uptake.

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According to Beatrice Nyagol, a researcher with the Kenya Medical Research Institute (KEMRI) Dapivirine ring was the first topical HIV prevention method to be submitted for regulatory approval. It is an intravaginal silicone ring, developed by the International Partnership for Microbicides (IPM) for HIV prevention.

Efficacy data shows that the ring reduces HIV risk by 35 percent, with recent data from open-label extension studies suggesting a greater reduction in HIV risk by about half. However, the ring does not reduce risk of Chlamydia, gonorrhea, syphilis or herpes, or unwanted pregnancy.

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There are studies underway examining the safety of a combined dapivirine-levonorgestrel ring that would protect against HIV infection and unwanted pregnancy, as well as different vaginal rings that combine antiretroviral and other medications to prevent STIs.

Antibody Mediated Prevention (AMP) study.
Another important research that may provide scientific breakthrough is the AMP study which enrolled about 1,900 adult women in sub-Saharan Africa who are at risk of HIV-1 infection.

Dr. Grace Mboya , a researcher , says the goal of AMP is to prevent HIV infection using a broadly neutralizing antibody (BNAb) against HIV given through an IV infusion (sometimes called a drip). While a vaccine teaches the body to make antibodies on its own, AMP involves giving the antibody directly to people.

Dr. Mboya says women are among those at highest risk of HIV infection in Africa. They have the greatest need for new tools to prevent HIV infection, and it is important to include them in studies looking at new prevention methods.

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Should the two studies be approved, HIV/ AIDS will no longer be a threat along the lake shores of Migori and Homabay Counties which have also recorded an increasing number of Kaposis sarcoma, a type of cancer that is associated with wakened immunity.

High prevalence rate in Western Kenya
Mary Nyandia, an oncology nurse at the Sori Lakeside Hospital, a facility that offers palliative care for patients from both Migori and Homa bay counties says the high HIV/ AIDS prevalence rates in these regions are attributable to the upsurge of sarcoma cases recorded at the facility.

Joshua Ocholla, HIV/AIDS coordinator in Homa Bay County says irresponsible and careless sexual behavior, myths, misconceptions and ignorance have catalyzed the spread of the virus among the fisher folk.

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The first case of HIV in Kenya was detected in 1984. By the mid-1990s, HIV was one of the major causes of illness in the country, putting huge demands on the healthcare system as well as the economy. In 1996, 10.5% of Kenyans were living with HIV, although prevalence has almost halved since then, standing at 5.9% by 2015. This progress is mainly due to the rapid scaling up of HIV treatment and care.

In 2016, 64% of people living with HIV were on treatment, 51% of whom were vitally suppressed. Kenya’s HIV epidemic is driven by sexual transmission and is generalized, meaning it affects all sections of the population including children, young people, adults, women and men.

The epidemic continues to be a major health crisis in the country with the top five HIV high-prevalence counties with a prevalence of more than 9% being Homa Bay, Kisumu, Siaya, Migori and Busia.



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