Modern HIV prevention: What’s next for women?
Recently, some of the world's leading scientists and researchers gathered in Boston at the Conference on Retroviruses and Opportunistic Infections (CROI). "What's next for women?" was the question on the minds of many, after results were released from two trials that looked at one of the most promising new HIV prevention tools of our time: the long-acting dapivirine vaginal ring, a female-controlled HIV prevention method that could potentially protect women for up to a month at a time.
ASPIRE (MTN 020) and The Ring Study (IPM 027) looked at the safety and effectiveness of these women-controlled devices; their results were among the most anticipated data to be released at the conference.
The news from CROI was encouraging and potentially far-reaching – trial results found the ring to be effective in preventing HIV infection among women (27% and 31% protection overall among the roughly 4,500 women enrolled in these two studies).
This is truly a major advance for the field of HIV prevention, especially for women. It is clear – as was the case with oral PrEP – that we need to move quickly to open-label and demonstration projects to understand the real-world impact of this new intervention.
The vaginal ring is one more addition to an already exciting array of antiretroviral-based biomedical options in the prevention toolbox that has ushered in a new era in HIV prevention. For the first time, a real prevention menu is beginning to take shape.
Despite immense progress in diagnostics and antiretroviral (ARV) treatment, every year roughly two million people worldwide become newly infected with HIV. The situation is particularly grim for women and young girls in sub-Saharan Africa, where women account for more than half of all people living with HIV, and the burden of disease continues to increase among young women. Offering a variety of effective prevention approaches to suit diverse needs for diverse populations at different times in their lives is the key to controlling the epidemic, at least until there is a vaccine and a cure.
Interventions that address gender-based violence and the socioeconomic needs of young women must also be part of this comprehensive response. Our focus needs to remain inclusive, involving community mobilization and leadership at all levels. It must also be broad, encompassing the biomedical, behavioural, and structural components of combination prevention while respecting, protecting, and promoting sexual reproductive health and rights.
There is still much more to be done. There is an urgent need to deploy the tools in the right way to the right people. At the same time, we must continue to explore new innovations that will improve and further expand the menu of prevention options for women. The exciting results from ASPIRE and The Ring Study bring new hope in this area.
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