What’s Next for the Dapivirine Ring

In March, initial results from the two open-label trials of the dapivirine vaginal ring (HOPE and DREAM) showed that adherence and efficacy improved over the earlier Phase III trials. Open-label studies, unlike Phase III studies, do not use a placebo, and all participants know they are using an intervention with evidence of a certain level of HIV protection. The ring is also advancing along the pathway to licensure. If approved, it will be the next major prevention option available since the US FDA approved oral PrEP in 2012.

The dapivirine vaginal ring is made of silicone and inserted in the vagina releases the antiretroviral drug, dapivirine, over the course of a month to protect against HIV.

In this episode of Px Pulse, Zeda Rosenberg of the International Partnerships for Microbicides, which developed the ring, explains the latest findings and spells out how, when, where and if the ring might become an available tool. A trial participant and community leader in Uganda, Ruth*, pulls back the curtain on the ups and downs of using the ring, and a Ugandan investigator with the REACH study, Carolyne Akello of the Makere University-Johns Hopkins University Research Collaboration, explains the importance of the this trial, the next step in testing the potential of this monthly vaginal ring for young women.

*Last name withheld for confidentiality.

From Research to Roll Out: Comparing oral PrEP to the dapivirine ring

These slides provide an overview of the process that takes an HIV prevention product from the final phases of research into the real world where it’s broadly available. Also included is a comparison of findings from research on the dapivirine ring and oral PrEP at key points along the process.

A PDF version is also available.

Map of HIV Prevention Research and PrEP Demonstration Sites in Kisumu, Kenya

This map demonstrates the breadth of HIV prevention research and demonstration projects in the Kisumu region of Kenya by site and type (e.g. daily oral PrEP, preventive Vaccines, etc.). This map was developed by Wits RHI with support from AVAC as part of the Coalition to Accelerate and Support Prevention Research.

Deprioritizing Women’s Lives in 2017

This short excerpt from our AVAC Report 2017 contains two stories: an update on hormonal contraception and HIV risk, including what to look out for in 2018, and an explanation of the damage caused by the Trump Administration’s expanded Global Gag Rule, preventing any organization receiving US global health funding from advocating for abortion as a family planning method.

Three Perspectives, Two Trials and One Big Goal

With more efficacy trials underway today than ever before in HIV prevention research, this episode of Px Pulse zooms in on two that have most recently launched: one of two trials testing a long-acting injectable antiretroviral called cabotegravir (HPTN 084), and the study of a “mosaic” vaccine developed by Janssen Pharmaceuticals (HVTN 705/HPX2008).

Px Wire January-March 2018, Vol. 11, No. 1

In this issue of Px Wire, we take a hard look at a host of major milestones coming up toward ambitious global targets for ending the epidemic. We also include detailed infographics on showing the status of oral PrEP rollout in the countries where trial sites are located, explaining the demographics of Africa’s “youth bulge” and its implications for the global response and more.

Target Tracking for Epidemic Control

Calculating progress toward the UNAIDS Fast Track Goals is complex but ambitious targets are the best kind. AVAC has long argued they propel action even if they aren’t met. But when it comes to achieving epidemic control, progress must be properly calculated, and can never be confused with success.

Appearing in Px Wire, this is a modified version of a graphic appearing in AVAC Report 2017.

Standard of Care in the Era of PrEP

Every research trial of a new HIV prevention option offers a package of services to protect participants from HIV. This standard of care is essential to the design of an ethical trial.

So what do we do now that oral PrEP has hit the world: It works if you take it; roll out is reaching some places and populations better than others. And people on PrEP often need support to stick with it. All this makes adding Oral PrEP a paramount question for trials. This month’s Px Pulse follows a recent summit in Cape Town South Africa where advocates, researchers and regulators confronted the high stakes of post-PrEP prevention research.

What’s the State of the Field? AVAC Report 2017

On the eve of World AIDS Day 2017, AVAC published its annual report on the state of the field. AVAC Report 2017: Mixed Messages and How to Untangle Them is a must-read for anyone tracking the progress of HIV prevention around the world. In this month’s episode of Px Pulse, AVAC’s Director of Strategy & Content Emily Bass shares highlights from the report and calls for action on the unfinished work of scaling up prevention.

2018 and HIV Prevention: AVAC’s Take

In this episode hear about recently published findings from a study out of Rakai, Uganda confirm that scaling up of a combination of existing interventions, such as voluntary medical male circumcision and antiretroviral therapy provides protection from HIV at the population-level. How do we apply these findings at the global level? How should advocates prepare for results—anticipated in 2019—of the ECHO trial that’s looking at the effect of hormonal contraceptives on HIV risk? And what needs to happen in 2018 to reach long-term global targets for ending the epidemic?