Microbicides: Innovative Solutions to Help Women Stay HIV-Free

This guest post was written by GHC Member International Partnership for Microbicides (IPM). IPM is a nonprofit organization dedicated to developing new HIV prevention technologies for women and making them available in developing countries where the epidemic has hit hardest. IPM collaborates with a global network of public, private, philanthropic, academic and civil society partners to develop products designed to empower women with the tools they need to protect themselves against HIV and improve their sexual and reproductive health, so they can live healthy and productive lives.

Why do women continue to be at high risk for HIV? Social expectations, cultural norms and economic inequities all limit women’s ability to negotiate safe sex practices, or even select their partners or the timing of sex. Condoms, while highly effective, are simply not a feasible option for many women. Women are also biologically more susceptible to HIV infection than men.

As a result, HIV/AIDS remains a serious epidemic among women. It is the leading cause of death globally in women ages 15-49. In sub-Saharan Africa, infection rates among women are alarmingly high—young women there are at least twice as likely to become infected with HIV as young men, putting their sexual and reproductive health at risk.

How can we stem the tide of HIV infection among women?
Women urgently need new prevention options, particularly discreet methods they can use without partner involvement. Among the most promising women-centered products are vaginal microbicides, biomedical products being developed to protect women from HIV during vaginal sex. They could come in different forms—such as a monthly vaginal ring developed by the International Partnership for Microbicides (IPM) recently shown to reduce women’s HIV risk—and other products in early development like films and tablets.

The flexible silicone ring, which women insert and replace themselves each month, slowly releases the antiretroviral drug dapivirine over the course of a month.

IPM’s dapivirine ring is the first long-acting HIV prevention method shown to safely reduce HIV risk and is under regulatory review.

What are the next steps for microbicides?
Several vaginal microbicides are being studied in preclinical studies or early-stage clinical trials. The most clinically advanced microbicide is IPM’s dapivirine vaginal ring, which is currently in open-label studies following late-stage efficacy trials. At the same time, IPM is seeking regulatory approval to license the product for public use. The monthly ring is under review by the European Medicines Agency and will be submitted to the South African Medicines Control Council and US Food and Drug Administration in 2018, followed by applications to additional regulatory agencies in Africa. The first regulatory decisions on the ring could come as early as 2019 in some African countries. If approved, the dapivirine ring would become the first microbicide licensed for HIV prevention.

Multipurpose products are also being developed that would offer women increased convenience by combining STI prevention and contraception in a single product. IPM has designed a three-month HIV prevention-contraceptive ring that entered its first safety clinical trial earlier this year.

 

How do microbicides fit in the HIV prevention landscape?
No one product will end the HIV epidemic. Women need multiple prevention options that they can choose from that makes sense for their lives, from monthly vaginal rings to daily oral ARV pills to products still in development like vaccines. Modeling studies show that a safe and effective microbicide like the dapivirine ring would have a significant impact on the epidemic while empowering women with tools they need to protect their sexual and reproductive health. And when women are healthier, so are their families and communities as a result.