Infectious Disease

Vaginal ring for HIV prevention authorized in 11 African countries

December 04, 2023

2 min read

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Key takeaways:

  • The dapivirine ring is approved or authorized for use in 11 African countries and available for use now in six.
  • Local manufacturing of the HIV prevention method is expected to bring costs down.

The dapivirine vaginal ring, a long-acting form of HIV prevention, has been licensed for use in 11 sub-Saharan African nations, according to an international nonprofit organization.

The flexible silicone ring, which slowly releases the antiretroviral drug dapivirine in the vagina over a 1-month period, has been approved or authorized for adults in Botswana, Eswatini, Kenya, Lesotho, Malawi, Namibia, Rwanda, South Africa, Uganda, Zambia and Zimbabwe, and is available in through implementation and pilot studies in six of these countries — Eswatini, Kenya, Lesotho, South Africa, Uganda and Zimbabwe — according to the Population Council.

IDN1123DapivirineApproval_Graphic_01_WEB

Although daily oral PrEP is more effective at preventing HIV infection, it is not a viable option for some women. Additionally, many women have said they prefer it over oral PrEP.

“Women need different choices for HIV prevention at different stages of their lives, and the ring could be a critically important option,” Anita Bhatia Garg, MS, senior director for strategy and commercial relations for the Population Council, said in a press release. “It complements existing HIV prevention tools and circumvents well-documented challenges that adolescent girls and young women face in taking pills on a daily basis.”

In addition to the growing availability of the dapivirine ring in Africa, the Population Council and its subsidiary APM South Africa are planning to award a license for the South African company Kiara Health to manufacture the ring locally. Moving production for African nations from Sweden, where the dapivirine ring is currently manufactured, is expected to “substantially” lower its cost for patients, the Population Council said.

The ring was endorsed by the European Medicines Agency in 2020, received WHO prequalification in 2020 and was included in WHO’s HIV prevention guidelines in 2021. According to the Population Council, more than 113,000 rings have been sold as of September 2023.

The nonprofit said it is also developing a ring that can be used for 3 months and expects to submit the longer duration ring for regulatory approval in the next 12 to 18 months.

“Women bear the brunt of the HIV/AIDS epidemic,” said Jim Sailer, executive director of the Population Council’s Center for Biomedical Research. “In sub-Saharan Africa, one adolescent girl or young woman becomes infected with HIV every 3 minutes. We cannot achieve the sustainable development goal of ending HIV by 2030 unless we curtail this epidemic in women.”

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