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The term “microbicide” refers to substances being studied that could be used in the vagina and/or rectum to reduce the risk of HIV infection via sexual exposure. Today, daily oral PrEP is the only HIV prevention tool for women that does not require partner negotiation at or around the time of sex. Access to PrEP is expanding, but more options are needed. Easy-to-use microbicides would fill an important HIV prevention need. They can be used discreetly and their effect is localized to the site of infection (the rectum or vagina) and not systemic (affecting the whole body), characteristics some people will prefer.

A range of microbicide strategies are under investigation, including gels, douches and the dapivirine vaginal ring, which is being considered for licensure. Developed by the International Partnership for Microbicides (IPM), the ring would be the first microbicide and the next prevention tool available since oral PrEP’s approval in 2012. For the latest developments in dapivirine ring research and plans for potential rollout, visit the dapivirine ring page on PrEP Watch.

Key Update

In this episode of Px Pulse, Zeda Rosenberg of IPM 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 pulls back the curtain on the ups and downs of using the ring, and a Ugandan investigator with the REACH study explains the importance of this trial.

March 30, 2018
What We're Reading

Dapivirine vaginal ring PrEP would be cost‐saving in KwaZulu‐Natal if prioritized to female sex workers. PrEP's impact on HIV prevention would be increased, with potential affordability, if prioritized to women by age or incidence.

May 10, 2019

GRFT and DPV nanoparticles were non-toxic and maintained bioactivity (IC50 values of 0.5 nM and 4.7 nM, respectively) in a cell-based assay. The combination of drugs in both unformulated and encapsulated in nanoparticles showed strong synergistic drug activity at 1:1 ratio of IC50 values. This is the first study to co-deliver a protein (GRFT) and a hydrophobic small molecule (DPV) in PLGA nanoparticles as microbicides.

April 16, 2019

Our data indicate that G1-S4/PD and G2-S16/PD combinations are promising candidates to be developed for vaginal microbicides with contraceptive activity.

April 2, 2019
International Journal of Nanomedicine

The National Institutes of Health announces the launch of REACH, a phase 2a trial evaluating safety and adherence to a vaginal ring containing dapivirine and oral emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) PrEP.

February 12, 2019
Contagion Live
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