Aspire trial results on Dapivirine Ring

2 April 2016

CAPRISA congratulates the ASPIRE and the Ring study teams for two well conducted studies. "Both these studies have generated valuable new findings and insights," said Professor Salim S. Abdool Karim, Director of CAPRISA in response to the trial results released at CROI on 22nd February, that showed, overall, the dapivirine vaginal ring reduced HIV incidence by 27% (95% CI: 1% to 46%) in ASPIRE and by 31% (95% CI: 1% to 51%) in the Ring trial. "It is reassuring that the results were consistent across the two studies, including the observation of higher protection in the sub-group of women > 21 years." Dr Lulu Nair, a senior research clinician at CAPRISA,  led the MTN study as the Site Principal Investigator at the CAPRISA eThekwini Clinical Research site. CAPRISA was one of 15 sites of this multinational trial.

"There was high hope that the monthly dapivirine ring would remedy the adherence problem seen in past trials of oral & topical pre-exposure prophylaxis (PrEP) and thereby achieve consistently high levels of protection against HIV. While the effectiveness of the dapivirine vaginal ring in preventing HIV is considerably lower than anticipated and hoped for, the success of the two trials in achieving high levels of adherence (82% in ASPIRE and 73% in the Ring Study) and regular monthly vaginal ring insertions, is encouraging, said Prof Abdool Karim.  

He explained that, "More research is needed to fully understand and overcome the remaining challenges for sustained adherence in this high-risk population as we look forward to the next set of approaches to HIV prevention in women that are currently being studied, including multi-purpose vaginal rings (for contraception and HIV prevention), injectable long-acting antiretrovirals, as well as injectable broadly neutralising antibodies for protection through passive immunity."  

"The high HIV incidence rates reported in both trials highlight the urgent need for appropriate HIV prevention technologies for women in Africa. Indeed, the ongoing high number of new HIV infections particularly in young women in Africa is one of the major obstacles to current efforts to end the global AIDS epidemic," commented Professor Quarraisha Abdool Karim, Associate Scientific Director of CAPRISA. "These two important studies highlight the challenges in developing technologies to prevent HIV in young women and provide further impetus for research to address this problem."