To put an end to the AIDS epidemic, researchers are working on findings more ways to prevent infection in populations that are at particularly high risk. One such population is adolescent girls and young women who are between the ages of 15 and 24.
In fact, the National Institutes of Allergy and Infectious Diseases (NIAID) reports that this group alone accounted for 20% of new infections among adults worldwide in 2015, even though they only accounted for 11% of the adult population.
To address these large numbers, preventive efforts tailored specifically for this population are needed. To this end, two teams of investigators reported findings from 2 different studies that focused on preventing HIV specifically in adolescents: a monthly vaginal ring and a daily oral tablet. The research was presented at the recent 9th International AIDS Conference on HIV Science. This article will focus on the trial for the vaginal ring; the first time that the ring had been tested in adolescent girls who were younger than 18 years of age.
A previous study, ASPIRE
, which evaluated the safety and efficacy of a dapivirine vaginal ring as a means of HIV prevention in women between the ages of 18 and 45, found that the ring provided 27% of protection overall, but no protection in women between the ages of 18 and 21; researchers postulated that the reason for this was poor adherence to the regimen. A follow-up analysis yielded more promising results: by adhering to the ring, women reduced their risk of infection by a promising 56%.
Investigators decided to test this means of prevention in adolescent girls in the phase 2a clinical trial they dubbed MTN-023/IPM 030 to see if it could be a safe and effective option for this population as well. They enrolled a total of 96 sexually-active girls between the ages of 15 and 17 at 6 different sites in the United States. The girls were randomly assigned to 1 of 2 groups: a group that would receive the dapivirine ring or a group that would receive a placebo ring. They were instructed to insert a new ring on a monthly basis for the duration of 6 months. During this time, the investigators kept an eye on the amount of dapivirine in their blood as well as in the used ring to guage how well the participants were adhering to their regimens.