Infectious Disease

New study reports higher adherence to HIV PrEP, vaginal ring in young women

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Nair G, et al. Abstract 2487. Presented at: International AIDS Society Conference (IAS); 18.-21. June 2021 (virtual).

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Nair does not report any relevant financial information. Please refer to the study for all relevant financial information from the other authors.

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Newly presented study results reported higher adherence to two HIV prevention methods – oral PrEP and dapivirin vaginal ring – in adolescent girls and young women in Africa than shown in previous studies, researchers said.

They presented the data during the International AIDS Society Conference on HIV Science.

Nair pullquote

“Current statistics show the persistent vulnerability and disproportionate impact of HIV infection on adolescent girls and young women in Africa. Young women desperately need acceptable HIV prevention options to address this problem ”, Gonasagrie Nair, MBChB, MPH, Protocol chair of the REACH study and senior lecturer at the Center for Medical Ethics and Law at Stellenbosch University in South Africa, said Healio. “Oral PrEP and the dapivirine vaginal ring have been shown to be effective in preventing HIV infection, but not in younger women, and this was due to poor adherence.”

PrEP has been approved in several countries in sub-Saharan Africa, and the dapivirine vaginal ring has been recommended by WHO for use by women over 18 years of age at significant risk of HIV infection and is currently under regulatory review, Nair noted.

“The REACH study was designed to assess whether these two products prevent HIV infection in young women, are safe to use, and are acceptable to them,” she said.

Nair and colleagues took in 247 adolescent girls and young women aged 16 to 21 from South Africa, Zimbabwe and Uganda who were not infected with HIV and who were not pregnant. During the first two study phases, participants were randomly assigned to either a monthly dapivirine ring or daily oral tenofovir disoproxil fumarate / emtricitabine (TDF / FTC) for 6 months and then switched to the second product for a further 6 months. Nair and colleagues rated safety based on Grade Two Adverse Events, adherence based on drug levels remaining in returned rings and plasma-dried blood stains for oral PrEP, and self-reported acceptability.

According to the researchers, most participants had at least moderate adherence to the dapivirine ring (77.8%) and oral PrEP (58.6%), while 50.2% had dapivirine and 22.4% oral PrEP – Users observed a high level of adherence. Grade 2 or higher adverse events occurred in 78% of ring users and 77% of oral PrEP users. Acceptance varied: 88.5% liked the dapivirine ring and 63.9% liked the oral PrEP.

“Young women can and are willing to use both PrEP and the vaginal ring when provided with tailored measures to support adherence,” said Nair. “Both PrEP and the ring were safe with no product use interrupted due to the ring or PrEP.”

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IAS Conference on HIV Science

IAS Conference on HIV Science

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