SOUTH AFRICA – The South African Health Products Regulatory Authority (SAHPRA) has approved the use of the monthly dapivirine vaginal ring for women 18 years and older to reduce the risk of HIV infection.
Dapivirine is an antiretroviral drug that belongs to a class of medicines known as non-nucleoside reverse transcriptase inhibitors that work against HIV by blocking its ability to make copies of itself once inside a healthy cell.
The vaginal ring is made of flexible silicone loaded with dapivirine that provides continuous release of the drug inside the vagina over the course of a month with low exposure elsewhere in the body.
The ring is supposed to stay in place for at least 24 hours to allow sufficient drug release to happen to ensure that the highest level of risk reduction is achieved through the sustained release of the drug.
It should not be removed to be cleaned nor does it need to be removed during the menstrual cycle but the ring should be replaced after a month.
The dapivirine vaginal ring will help minimize side effects of HIV infection in woman and girls as well as reduce the risk of developing HIV resistance.
The South Africa National Department of Health announced that it will review the clinical indication and the implementation requirements approved by SAHPRA concerning the HIV prevention ring.
“Implementation policy and guidelines are required for public healthcare facilities thus they will have to be drafted and presented to the National Health Council,” declared the Department of Health.
The department will also assess the dapivirine ring regarding its effectiveness, cost of procurement and delivery along with its potential impact on HIV incidence in South Africa.
In addition, the existing HIV prevention and Oral Pre-Exposure Prophylaxis guidelines in the country will require updating with additional information pertaining to the delivery of the dapivirine ring.
South Africa has the biggest HIV epidemic in the world with 7.7 million people living with HIV and nearly 4,500 South Africans are newly infected every week out of which one-third are adolescent girls/young women ages 15-24.
The human immunodeficiency virus destroys white blood cells in the immune system and replicates itself inside these cells which impairs the function of immune cells causing infected individuals to gradually become immunodeficient.
The approval of the HIV prevention ring for South African women and girls is expected to help reduce HIV incidence among individuals in the nation.
In addition, the ring offers women a discrete way to reduce their HIV risk when they cannot or choose not to use higher efficacy methods like daily prevention pills.
South Africa is a pioneer of the dapivirine vaginal ring use in the African continent and it is already recommended as an additional HIV prevention option for women at substantial risk of HIV infection by the World Health Organization.
The health organization also approves other HIV prevention methods like the use of male and female condoms, HIV prevention pills and voluntary medical male circumcision.
Moreover, South Africa recently rolled out the highly effective injectable version of pre-exposure prophylaxis called long-acting cabotegravir to bolster the fight against HIV virus in the country.
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