THE CONTRACEPTIVE GAME IS ON THE VERGE of a change for the better. Researchers are currently developing two new vaginal ring technologies that prevent pregnancy and a variety of dangerous and difficult-to-treat STDs. Today, condoms are the go-to barrier method for preventing STD transmission, but individuals concerned about unwanted pregnancy and looking for a highly-effective contraceptive must select another form of birth control to that end. Women may soon have another option.
In 2013, CONRAD presented research on its vaginal ring technology at the American Association of Pharmaceutical Scientists Annual Meeting and Exposition. Having been tested on rabbits and sheep, this ring administered levonorgestrel, the contraceptive found in Mirena and Plan B, and tenofovir, a microbicide used in the treatment of HIV and hepatitis B, for a period of 90 days. At the time, researchers listed HIV and herpes simplex virus (HSV) 2 — genital herpes — as the two STDs their ring would target, stating that they had plans to conduct clinical trials in 2014.
CONRAD’s Levonorgestrel (LNG)/Tenofovir (TFV)-Releasing IVR was the first product of its kind to enter human trials. In November 2014, the non-profit released a statement confirming the trial’s launch in the U.S. and the Dominican Republic. At the time of this writing, there have been no further updates.
As that ring entered Phase 1 of human testing, another product was showing promise in research done with rhesus macaques in Cape Town, South Africa. The MZCL IVR contains levonorgestrel, and three anti-STD agents: MIV-150, to combat HIV; zinc acetate, to combat HIV and HSV-2; and carrageenan, to combat HSV-2 and HPV. Monkeys in the trials were given one of four ring types: levonorgestrel-only, MZC-only, the combination ring, or a placebo. Although the sample size was miniscule, the MZCL IVR animal tests showed promise, with the combination ring preventing all HIV transmission and most HSV-2 infection.
Not all of the vaginal ring technologies in development are concerned with preventing pregnancy. As of November 2014, CHAARM project researchers are working on an HIV-preventive ring containing dapivirine and darunavir.
An STD-preventive ring from Jean Monnet University is currently generating the most hype, however. In September 2015, PhD candidate Meriam Memmi presented her findings at the 55th Interscience Conference on Antimicrobial Agents and Chemotherapy. The Jean Monnet University vaginal ring releases doses of tenofovir and acyclovir for 50 days to prevent people with vaginas from contracting HIV, HSV-2, and hepatitis B.
Speaking on the future of her research, Memmi states that the Jean Monnet University ring has not been imagined with a Western market in mind. Instead, the team hopes to “produc[e] them commercially at high rate and low cost,” in order to create an affordable STD-preventative for women in developing countries. Memmi observes, “[i]t is difficult for women in these countries to master the prevention of STIs since the use of condoms is mainly under the control of men.”
Young brides in developing countries are at a much higher risk of contracting HIV at early ages, due to child marriage practices that wed them to much older men. Because vaginal rings may be used discreetly and without cooperation from partners, these new vaginal ring technologies place the power of HIV prevention in wives’ hands.
Some may wonder why researchers are developing vaginal ring technologies without contraceptive agents. If the problem, as stated above, is that individuals must currently use two forms of birth control in order to prevent both pregnancy and STDs, creating products that only serve one purpose doesn’t appear to be much of an improvement on the current market. However, vaginal rings that are non-contraceptive and STD-preventive may be more effective in the developing countries Memmi and others have addressed.
Why? Because condom-use promotions have been ineffective in countries with the highest incidences of HIV/AIDs, due to societal expectations regarding reproduction and cultural associations of the male condom with AIDs and infidelity. In these areas, vaginal rings that prevent the transmission of viral infections without contraceptive effects may be more widely adopted by members of both sexes.
The focus on countries most affected by HIV/AIDs is not limited to the Jean Monnet University researchers. Both CONRAD and the MZCL IVR researchers have noted that their rings’ extended efficacy periods make them more accessible to low-income individuals, and have observed the need for new contraceptives and STD-preventives in the developing world.
Although these new vaginal rings can obviously be of most help to individuals and families in developing countries, they have applications in the West as well. With HIV medications now capable of suppressing the infection to non-transmittable levels, HIV-negative women no longer have to risk contracting the disease in order to conceive with their HIV-positive partners, so the applications for partnered couples in the West are minimal. However, these rings could provide single individuals with self-initiated, multipurpose contraceptive options that are currently unavailable in today’s market. And that’s something we can all enjoy.