Put a ring on it

The vagina ring that provides secret HIV protection for women with cheating partners – or those who refuse to wear a condom

Women in Malawi have adopted a secret preventive measure against HIV infection from their partners who they suspect of cheating or who refuse to wear a condom. A silicon ring is inserted in the vagina which secretes an antiretroviral drug that prevents the virus being contracted.

A similar size to the contrace p t ive diaphragm, the device – that fits high up inside the vagina – is effective for a month after which time it should be replaced. The advantages of it are that women can insert it themselves and men reportedly cannot feel it.

Those who regularly used it – coated with an experimental medication dapivirine –were up to 92 per cent less likely to get the deadly virus through unprotected sex, experts found.

Cultural practices in Malawi make safe sex difficult for women to negotiate. At least 10 percent of the country's population has HIV. Women in Malawi are increasingly becoming concerned about their sexual health as men in the country have many sexual partners. There are currently one million people in Malawi living with the disease according to The Joint United Nations Programme on HIV and AIDS.

'The women are geared to put on the ring. Yeah, they are anxious indeed,' said a midwife involved in a trial to test the ring, which costs $7. I did special training in community health, I am really proud and I have put all my energy in this project. HIV in Malawi was really bad, our wards were full, I can say everybody has lost their loved ones.

'Normally in our culture negotiating sex with a partner is rather difficult, it is really a challenge, the women just want something to get protected with.'

Studies, which are still ongoing, show one in three women using the ring are protected by HIV. Dr. Annelene Nel, who is leading the clinical trials, says that it is better to save one out of three than none at all. She said: 'For women who cannot negotiate safe sex and cannot negotiate condom use this may be their only option.'

Research published last year found 27 per cent fewer women acquired HIV in the group using dapivirine compared to those using a placebo ring containing no active drug.

Developed by the International Partnership for Microbicide, the ring tested in the study contained 25 mg of dapivirine, about 4 mg of which gets released over 28 days.

More than 2,600 HIVnegative women between the ages of 18 and 45 from Malawi, Uganda, South Africa and Zimbabwe were analysed. They were categorised into one of four groups depending on how often they used the ring, ranging from nonuse to near perfect ring use; the ring appeared to be far more effective when used most or all the time.

Elizabeth Brown, from the University of Washington, said: ' Adherence to HIV prevention strategies is not perfect, and we knew that not all women used the ring consistently, so we developed an analysis to explore the degree of HIV protection that was associated with consistent use. Across all analyses we saw high adherence was associated with significantly better HIV protection.'

First re gulatory approvals for the vaginal ring could be granted in 2018.