scholarly journals Introducing the progesterone contraceptive vaginal ring in sub-Saharan Africa

2016 ◽  
Author(s):  
Keyword(s):  
Vaginal Ring ◽  
Sub Saharan Africa ◽  
Contraceptive Vaginal Ring ◽  
Sub Saharan

scholarly journals Introducing the Dapivirine Vaginal Ring in Sub-Saharan Africa: What Can We Learn from Oral PrEP?

2021 ◽  
Author(s):  
Neeraja Bhavaraju ◽  
Kathleen Shears ◽  
Katie Schwartz ◽  
Saiqa Mullick ◽  
Patriciah Jeckonia ◽  
...  
Keyword(s):  
Scale Up ◽  
Vaginal Ring ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
Prevention Method ◽  
Long Acting ◽  
Exposure Prophylaxis ◽  
Effective Use ◽  
Method Mix ◽  
Oral Prep

Abstract Purpose of review Clinical trials have found that the dapivirine vaginal ring (DVR) is safe to use and effective at reducing women’s risk of acquiring HIV infection. As countries prepare for the introduction of this novel long-acting, woman-controlled prevention method, an examination of key learnings from oral pre-exposure prophylaxis (PrEP) delivery will help programs leverage successful innovations and approaches to support DVR scale-up and expand the method mix for HIV prevention. Recent findings Intensive efforts over the past 5 years have yielded lessons on how to facilitate access to oral PrEP; expand service delivery for PrEP; address the knowledge, attitudes, and skills providers need to support PrEP initiation and effective use; develop messaging that builds community and partner support and combats stigma; and understand the cyclical nature of PrEP use. Summary Evidence from oral PrEP introduction and scale-up can help inform and expedite DVR introduction.

Impact of Women’s Home Environment on Use of the Dapivirine Vaginal Ring for HIV Prevention in Sub-Saharan Africa

2021 ◽  
Author(s):  
Margaret W. Gichane ◽  
◽  
Ariana W. K. Katz ◽  
Kenneth Ngure ◽  
Rachel Scheckter ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Home Environment ◽  
Vaginal Ring ◽  
Sub Saharan Africa ◽  
Sub Saharan

Safety, Acceptability and Adherence of Dapivirine Vaginal Ring in a Microbicide Clinical Trial Conducted in Multiple Countries in Sub-Saharan Africa

2020 ◽  
Author(s):  
Lungwani Muungo
Keyword(s):  
Clinical Laboratory ◽  
Plasma Concentrations ◽  
Vaginal Ring ◽  
Sub Saharan Africa ◽  
Trial Participant ◽  
Self Reports ◽  
Sub Saharan ◽  
Post Trial ◽  
Hiv Negative

BackgroundThis was the first microbicide trial conducted in Africa to evaluate an antiretroviral-containingvaginal ring as an HIV prevention technology for women.ObjectivesThe trial assessed and compared the safety, acceptability and adherence to product use ofa 4-weekly administered vaginal ring containing the antiretroviral microbicide, dapivirine,with a matching placebo ring among women from four countries in sub-Saharan Africa.Methods280 Healthy, sexually active, HIV-negative women, aged 18 to 40 years were enrolled with140 women randomised to a dapivirine vaginal ring (25 mg) and 140 women to a matchingplacebo ring, inserted 4-weekly and used over a 12-week period. Safety was evaluated bypelvic examination, colposcopy, clinical laboratory assessments, and adverse events.Blood samples for determination of plasma concentrations of dapivirine were collected atWeeks 0, 4 and 12. Residual dapivirine levels in returned rings from dapivirine ring userswere determined post-trial. Participant acceptability and adherence to ring use wereassessed by self-reports.

scholarly journals Experiences with simultaneous use of contraception and the vaginal ring for HIV prevention in sub-Saharan Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jonah Leslie ◽  
◽  
Flavia Kiweewa ◽  
Thesla Palanee-Phillips ◽  
Katherine Bunge ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Side Effects ◽  
Hiv Prevention ◽  
Vaginal Ring ◽  
Sub Saharan Africa ◽  
Nulliparous Women ◽  
Negative Side Effects ◽  
Sub Saharan ◽  
Long Term Impact ◽  
Depth Interviews

Abstract Background Clinical trials have found that a monthly dapivirine vaginal ring was well-tolerated and reduced HIV-1 risk among women in sub-Saharan Africa. However, in order for the ring or other novel prevention methods to have optimal impact, it is necessary to understand and address women’s challenges to uptake and adherence. This paper provides insight into a few key challenges noted by women using the ring and contraceptives simultaneously. Methods The qualitative portion of the MTN-020/ASPIRE study consisted of data collection using single in-depth interviews, serial in-depth interviews, and focus group discussions, conducted with 214 participants across 15 sites in Malawi, South Africa, Uganda and Zimbabwe. A coding team used qualitative analysis software to identify themes within the interviews. Results The primary qualitative themes among participant data pertained to side effects. Participants reported negative side effects related to menses, in some cases attributing these effects to their contraceptives and in others to the vaginal ring. Participants also expressed concern over the long-term impact of contraception and ring use on fertility, including the reversibility of the contraceptive, especially among nulliparous women. Conclusions Women’s attitudes toward contraceptives can impact their willingness to concurrently use and adhere to a novel HIV prevention product. To optimize the potential of both prevention products, researchers should pre-emptively address concerns about contraceptive impact on fertility and counsel women about the expected side effects of contraceptives versus the ring. Clinical trials identifier NCT01617096. Registered on 6-12-2012 at clinicaltrials.gov https://clinicaltrials.gov/ct2/show/NCT01617096

Vaginal Ring Adherence in Sub-Saharan Africa: Expulsion, Removal, and Perfect Use

2012 ◽  
Vol 16 (7) ◽  
pp. 1787-1798 ◽  
Author(s):  
Elizabeth T. Montgomery ◽  
A. van der Straten ◽  
H. Cheng ◽  
L. Wegner ◽  
G. Masenga ◽  
...  
Keyword(s):  
Vaginal Ring ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Negative rumours about a vaginal ring for HIV-1 prevention in sub-Saharan Africa

2019 ◽  
Vol 21 (11) ◽  
pp. 1209-1224 ◽  
Author(s):  
Miria Chitukuta ◽  
Zoe Duby ◽  
Ariana Katz ◽  
Teopista Nakyanzi ◽  
Krishnaveni Reddy ◽  
...  
Keyword(s):  
Vaginal Ring ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
Hiv 1

Vaginal Ring Adherence in Sub-Saharan Africa: Expulsion, Removal, and Perfect Use

2020 ◽  
Author(s):  
Lungwani Muungo
Keyword(s):  
Hiv Prevention ◽  
Hormone Replacement ◽  
Vaginal Ring ◽  
Sub Saharan Africa ◽  
African Women ◽  
Prevention Trials ◽  
Sub Saharan ◽  
Prevention Method ◽  
Prevention Methods ◽  
Hiv Negative

In sub-Saharan Africa, HIV incidence andprevalence remain disproportionately high among women.Vaginal rings (VRs) have been formulated for the deliveryof antiretroviral-based microbicides, and their favorablesafety and tolerability profiles reported in clinical studies.Although the concept of drug release through a VR hasexisted since 1970, and VRs have been marketed since1992 for contraceptive or hormone replacement purposes,VR use as a microbicide delivery system is a novelapplication. This is the first study to evaluate VR adherenceamong African women in the context of its potential use asan HIV prevention method, to examine predictors ofadherence, and to describe clinical or contextual reasonsfor VR removals or nonadherence. This was a randomizedtrial of the safety and acceptability of a placebo VR wornfor 12 weeks in 170 HIV-negative, African women aged18–35 in four clinic sites in South Africa and Tanzania.The findings suggest that adherence to VR use in thecontext of HIV prevention trials in these communitiesshould be high, thereby enabling more accurate assessmentof an active microbicide safety and efficacy.Keywords Vaginal ring ? Adherence ? Sub-SaharanAfrica ? Female-controlled HIV prevention methods ?Microbicide delivery

scholarly journals “The state of mind tells me it’s dirty”: menstrual shame amongst women using a vaginal ring in Sub Saharan Africa

2019 ◽  
Vol 60 (1) ◽  
pp. 72-86 ◽  
Author(s):  
Zoe Duby ◽  
Ariana Katz ◽  
Petina Musara ◽  
Josephine Nabukeera ◽  
Chifundo Colleta Zimba ◽  
...  
Keyword(s):  
The State ◽  
Vaginal Ring ◽  
Sub Saharan Africa ◽  
State Of Mind ◽  
Sub Saharan
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