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.

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).

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.

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?

Testing Long-Acting PrEP, Easier Said Than Done

In this episode of AVAC’s Px Pulse podcast series, leading researcher Dr. Deborah Donnell tells us why the HIV Prevention Trials Network (HPTN) changed the design of one of two trials testing long-acting cabotegravir, as an injectable PrEP.

PrEP and Trial Design — A no brainer for some

In this episode of AVAC’s Px Pulse podcast series, Slim Abdool Karim, co-principal investigator of the landmark CAPRISA 004 study, talks about why designing trials with oral PrEP is a must—scientifically and ethically.

Golden Age or Fools Gold?

In this episode of AVAC’s Px Pulse podcast series, Carl Dieffenbach, Director of NIH’s Division of AIDS, tells AVAC where he sees the most promise in the field of HIV prevention and what it will take to “put out the fire.”

Trial Trial Again: Getting research right for adolescents

Both research and advocacy for HIV prevention are intensifying their focus on young people. Bringing interventions that work for this population holds unique challenges.

In this episode of AVAC’s Px Pulse podcast series, AVAC’s Manju Chatani-Gada explores how and why prevention research must reach the next generation.