Women who used an experimental vaginal ring intended to provide protection from HIV transmission report that the sexual satisfaction or pleasure was not negatively impacted by use of the ring.1

Through the ASPIRE (A Study to Prevent Infection with a Ring for Extended Use;2 ClinicalTrials.gov Identifier NCT01617096) study, researchers evaluated whether the use of a dapivirine vaginal ring was effective in preventing HIV-1 in healthy, sexually active women. Over 2600 women between 18 and 45 in Malawi, South Africa, Uganda, and Zimbabwe were enrolled.

Study data and insights were shared at the 2016 HIV Research For Prevention (HIVR4P) meeting.

Study staff interviewed 214 participants to obtain qualitative data about their sexual experiences during the trial. Nicole Laborde, PhD, MPH, of the RTI International in Durham, North Carolina, and colleagues analyzed responses.


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Although most women felt that the ring did not negatively impact regular sexual intercourse, some women reported decreased sexual pleasure and satisfaction due to concerns that their partner would notice the ring during sex. As a solution, some women removed the ring before sex—a practice not recommended by study investigators.

“Women need an HIV prevention modality that offers safe, effective protection and is practical for use in their daily lives,” said Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID), in a National Institutes of Health (NIH) press release. The NIAID was a primary funder of the ASPIRE study.

“Women enrolled in the MTN-020/ASPIRE study reported that the experimental vaginal ring generally did not intervere with sexual intercourse, which is an encouraging sign that this product could appeal to a larger group of women at risk for HIV infection,” Dr Fauci added.

Additional research led by Ariane van der Straten, PhD, MPH, also of RTI International, found that women’s concerns about using the experimental ring significantly decreased during the study. Participants were asked, “How worried are you about having a vaginal ring inside you every day for at least a year?” At the start of the study, 29% of women reported this as a concern, whereas only 4% indicated this as a concern during follow-up.

“Sub-Saharan African women have a broad range of sexual experiences and relationship dynamics, and we are learning more about how these diverse behaviors and circumstances influence the use of the ring,” said Thesla Palanee-Phillips, MMedSci, PhD, MSc, of the Wits Reproductive Health and HIV Institute in Johannesburg, South Africa. “While we have found that most women do disclose ring use to their primary partners, it is reassuring that adherence is not affected for the significant minority of women who choose to use it more discreetly.”

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References

  1. Women report vaginal ring for preventing HIV had little effect on sexual intercourse [news release]. Bethesda, MD: National Institutes of Health. Published October 18, 2016. Accessed October 31, 2016.
  2. Palanee-Phillips T, Schwartz K, Brown ER, et al. Characteristics of women enrolled into a randomized clinical trial of dapivirine vaginal ring for HIV-1 prevention. PLoS One. 2016;10(6):e0128857. doi: 10.1371/journal.pone.0128857