Abusive partners can sabotage ARV ring

WOMEN in abusive relation- ships are less likely to use the vaginal ring that releases antiretroviral (ARV) medicine slowly over a month.

The latest findings are from a group of 2 629 women, 1 426 of them in South Africa, and show that exposure to social harm decreases adherence to the vaginal ring containing dapirivine.

Results from ASPIRE – a study to prevent infection with a ring for extended use, and phase 3 trial – were first released earlier this year, having enrolled women aged between 18 and 45 at 15 trial sites in Malawi, Uganda, South Africa and Zimbabwe between 2012 and last year.

The study showed HIV risk was reduced by almost a third in women using the ring and that HIV risk was reduced significantly more among women 25 years and older who were found to be 61 percent less likely to get HIV.

However, researchers also conceded that many younger women did not keep the ring in for the entire month.

Dr Panalee Phillips, the director of network trials at the Wits Reproductive Health and HIV Institute, spoke on the new findings on social harms (intimate partner violence) at the biennial HIV Research for Prevention Conference in Chicago on Tuesday.

As a group, the women were overall 1.5 times less likely to use the ring and were up to 2.5 times less likely to use it if they had experienced social harm.

Of the 2 629 women, 94 reported social harm – 85 of which were partner related.

But of concern to Phillips was that only 10 percent of the women defined the violence as having a negative impact on them.

“Looking at factors affecting adherence is such a complex thing. It’s difficult for some women to tell their men they have a sexually transmitted infection, for example, because it could trigger violence. Women need to know it’s not normal to be exposed to social harm and the good thing was that the women who reported the incidents of social harm received counselling,” Phillips said.

She continued: “Violence against women is a significant problem globally, and particularly so in the communities where we conducted ASPIRE. Disclosing exposure to intimate partner violence was a major step forward for many of these women, who are often too afraid to talk openly, and an acknowledgement to trial sites that created safe environments that women felt comfortable to seek help from.”