Background
Adolescent girls and young women in sub-Saharan Africa remain one of the most at-risk populations for HIV, with infections three times those of adolescent boys and young men in the region (World Health Organisation) There is therefore an urgent need to explore all possible ways of preventing new HIV infections. Since November 2020, the dapivirine ring has been recommended by WHO. This followed the positive scientific opinion from the European Medicines Agency on the use of the ring for HIV prevention, which was granted in July 2020.
East Africa was among the regions where the study on the dapivirine ring was conducted and countries such as Uganda and Kenya had demonstrated willingness to be among the “early adapters”. In the past two years, Uganda, Kenya and Rwanda formally approved the dapivirine ring as a prevention tool. Women-led advocacy is needed to accelerate the roll-out and affordability of the Ring, and active community leadership is urgent to support increased awareness and demand creation for the Ring.
Objectives
- To contribute to a reduction in new HIV infections among women and girls in Uganda, Kenya, Tanzania and Rwanda through advocacy for approval and rollout of the dapivirine ring
- Awareness raising and demand creation among women and girls for this new HIV prevention tool.
Results
- The national drug authorities of Uganda, Kenya and Rwanda have approved the dapivirine ring as an HIV prevention tool (not a direct result of Empowering project)
- 4 EmpoweRing champions lead dapivirine ring work and host WhatsApp literacy sessions with 50+ young women in each country
- 200 Adolescent girls and young women were trained in HIV prevention advocacy. They are instrumental in spiking dialogues on dapivirine ring and country/regional advocacy endeavors on the ring with the leadership of the dapivirine ring country champions
- Supported CSOs in the 4 countries to participate in technical working groups, review of national guidelines, writing teams, planning meetings, (inter)national conferences and other advocacy platforms
- Created awareness on the dapivirine ring and choice in prevention products through online events and community campaigns
- Supported the development of The HIV Prevention Manifesto, launched in September 2023
About the dapivirine vaginal ring
The dapivirine ring is the first long-acting, women-controlled prevention tool. Women could use it discreetly at times in their lives when they may be unable to negotiate condom use or to consistently use daily oral PrEP. The monthly ring is an important new option for women, who bear the greatest burden of HIV and AIDS. Developed by IPM (now Population Council), the dapivirine ring is the first to adapt a medical technology commonly used to deliver hormones to women to instead deliver an ARV drug to prevent HIV. The dapivirine ring safely reduces HIV infection overall by half (modelling data). In the DREAM study, the HIV incidence rate was 62% lower than an imputed placebo incidence rate (Nel et al. 2021).
Population Council is developing a longer duration dapivirine ring that women would use for three months, to significantly lower annual costs and offer a woman a more convenient option to protect themselves. Development of this longer duration ring will be completed and submitted for regulatory approval in 2024-2025.
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