Dapivirine vaginal ring: SA rollout put on ice for now

Dapivirine vaginal ring: SA rollout put on ice for now
The dapivirine vaginal ring will soon be available at public health facilities. (Photo: Freepik)

South African women will have to wait before laying their hands on the newly-approved dapivirine vaginal ring (DPV-VR – while the National Department of Health assesses the effectiveness of the HIV prevention device.

Department of Health (DOH) spokesperson, Foster Mohale, explained the reasons for the rollout delay.

The department will review the clinical indicators and the implementation requirements approved by the South African Health Products Regulatory Authority (SAHPRA). We will assess the ring’s effectiveness, the cost of procurement product, the delivery requirements, and the potential impact on HIV incidence,” said Mohale. 

HIV prevention

The World Health Organisation (WHO) states the DPV-VR is intended to reduce the risk of acquiring HIV. This especially applies to women who engage in vaginal sex, who can use it as a complementary prevention approach in addition to other safe sex practices. The ring must be worn inside the vagina for a period of 28 days after which it should be replaced.

Mohale said healthcare workers also need to be trained on how to use the DPV-VR and approved implementation policies and guidelines will also be required.

“The support of the product developer and the donor community will be enlisted to make the product available for implementing at selected health facilities,” said Mohale.

HIV prevalence

A Statistics South Africa report, based on mid-year population estimates, released last July, stated that the estimated HIV prevalence rate is 13,7%. The total number of people living with HIV is estimated at approximately 8.2 million for adults aged between 15 and 49. This means that almost 20% of the population is HIV positive. 

Mohale said that women, who are at the highest risk of contracting HIV, will be targeted first.

“The availability of the product will depend on the aforementioned assessment. If offered through the public health system, it will be offered according to existing public health prescripts,” he said. 


Mohale further stated that the DPV-VR could be a game-changer in terms of fighting HIV infections for women.

Speeding up the process

Nelson Dlamini, Communications Manager at the South African National Aids Council (SANAC), said the organisation will engage the DOH to speed up the process. He said the availability of the dapivirine ring at public health facilities will ensure equitable access.

“We must expedite the process of making it available at all public health facilities. This will ensure equitable access to this groundbreaking HIV prevention commodity, especially for key and vulnerable populations,” Dlamini said.

Dlamini further stated that making the ring available will help fight new HIV infections among adolescent girls and young women. 

“The ring is a game-changer in the basket of prevention options currently available to women. It gives more power to them; it is discrete and convenient to use. Hopefully, the introduction of the Dapivirine vaginal ring will contribute towards changing the narrative,” said Dlamini.

He added: “Generally, women and girls, aged between 15 and 24, are the most vulnerable to HIV. The ring is recommended to all women from the age of 18. However, stakeholders should explore ways to best reach those most at risk.”  

SA on the right path

Dlamini said that the country is on the right path towards the fight against HIV.

“South Africa has continued to make significant progress with its HIV response. We have surpassed the first 90 of the UNAIDS 90-90-90 target and we are now working harder to surpass all three,” added Dlamini.

The UNAIDS 90-90-90 target stated that by 2020, 90% of all people living with HIV should know their HIV status. Another 90% of all people with diagnosed HIV infection should receive sustained ARV therapy and 90% of all people receiving therapy, should have viral suppression. -Health-e News


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