By Sharon Atieno

South Africa joins Zimbabwe to become the leading countries in Africa to approve the use of Dapivirine vaginal ring as a HIV prevention method for women.

Developed by the International Partnership for Microbicides (IPM), the vaginal ring is a longer-acting HIV prevention product made of flexible silicone, that slowly releases the antiretroviral (ARV) drug dapivirine directly in the vagina at the site of potential infection, with minimal exposure elsewhere in the body.

Replaced on a monthly basis, the product has been proven to be effective in two Phase III studies. These are the Ring Study, conducted in South Africa and Uganda, and the other, ASPIRE, carried out in four countries including South Africa.

The Ring Study showed an HIV reduction of 35% among women using the ring while the ASPIRE study demonstrated a 27% reduction in risk.

In a statement, Zuki Pinini, Acting Deputy Director-General for HIV/AIDS, TB, Maternal and Child Health, National Department of Health, South Africa welcomed the approval by the South African Health Products Regulatory Authority (SAHPRA), adding that the product is the first long-acting biomedical HIV prevention method option available for HIV-negative women especially, those who find it difficult to take an oral pill daily or other methods.

Pinini added that they look forward to working with IPM to make the dapivirine ring accessible to women in South Africa.

Sharing similar sentiments, Dr. Zeda Rosenberg, IPM’s founder and Chief Executive Officer said the approval is a positive step towards offering women more prevention options they can use to control their health on their own terms.

Besides, Dr. Rosenberg expressed interest in working with the South African government and partners to incorporate the monthly ring into the country’s health system.

In South Africa, like other countries across sub-Saharan Africa, women bear the greatest burden of HIV/AIDS, with nearly two-thirds of new adult infections occurring among women. In South Africa, every week, nearly 2,700 women ages 15 and older acquire HIV.

“This is a critical step forward in providing a new prevention option that many South African women need and can use,” said Mitchell Warren, AVAC executive director.

“It will be important for South Africa to ensure that the Ring is integrated into HIV prevention guidelines and made available to women as quickly as possible. Regulatory approval of the Ring must be accompanied by strategic, effective and equitable rollout that transforms the growing list of HIV prevention options into real and accessible choices for the women most in need of HIV prevention.”

In 2021, the World Health Organization(WHO) recommended the dapivirne vaginal ring as an additional prevention choice for women at substantial risk of HIV infection as part of combination prevention approaches.

Other prevention methods include male and female condoms, daily oral PrEP, voluntary medical male circumcision (VMMC) and injectable cabotegravir (CAB) in some countries