Janet Ogundepo
Maternal health experts have advocated the introduction and adoption of vaginal rings that protect against Human immunodeficiency Virus.
The long-practising gynaecologists, in separate interviews with PUNCH Healthwise, stated that the introduction of the VRs would contribute to the reduction of new HIV infections.
According to the World Health Organisation, HIV is an infection that attacks the body’s immune system. It can be transmitted through contact with the blood, breast milk, semen and vaginal secretions from persons living with HIV.
The Joint United Nations Programme on HIV and AIDS, a global alliance of 11 United Nations organisations that aims to end Acquired immunodeficiency syndrome by 2030, says that 39 million people globally were living with HIV in 2022.
Globally, 85.6 million people have become infected with HIV and 40.4 million people have died from AIDS-related illnesses.
In Nigeria, about 1.9 million people were estimated to be living with HIV in 2021.
Data from the WHO also shows that HIV is the leading cause of death among women of reproductive age and accounts for 60 per cent of new infections.
The Vaginal rings contain a drug called dapivirine that slowly releases into the body of the woman for a month.
It is used as pre-exposure prophylaxis, particularly used by people at risk of HIV to prevent them from getting infected.
The device is currently used in a few countries and is recommended by WHO.
WHO also recommended that additional preventive measures like the use of condoms be used together with the vaginal rings.
Recently, a company in South Africa announced its plans to begin local production of the rings to make them available and affordable to its citizens.
Professor Oluwarotimi Akinola
Speaking on the development with our correspondent, a Professor of Obstetrics & Gynaecology, Oluwarotimi Akinola, stated that the vaginal rings are a pre-exposure medicine that prevents against being infected with HIV.
The former president of the Society of Gynaecology and Obstetrics of Nigeria further confirmed that the VR was currently unavailable in Nigeria, stating that its introduction into the country was beneficial to the prevention of the HIV spread in the country.
“In theory, it would be wonderful because it would reduce the burden of the need for the procurement of highly active antiretroviral drugs. It would certainly help but it is not yet available in Nigeria. Trials (of the device) have shown that it contributed positively in that area.
“We are always advocating that people have options because the availability of options is usually good. Should it be brought into Nigeria, it would be beneficial and it would be another weapon in the arsenal,” Akinola said.
The gynaecologist also urged Nigerians to know their HIV status to prevent the spread of the infection.
The don said, “The major way to prevent new infection is for everyone to know their status. That everyone uses prophylaxis at all times is not going to work. The use of highly active antiretroviral drugs suppresses viral load so that infected people cannot infect others if their viral load is low, less than 1,000 copies per ml. So the implication is for people to know their status and use their drugs.”
Also, a Consultant Gynaecologist and Obstetrician at the Aminu Kano Teaching Hospital, Kano State, Dr Sule Abdullahi, said that the dapivirine contained in the vaginal ring is an HIV preventive drug that was beneficial to reducing the infection rate of HIV.
The gynaecologist called for the adoption of the device in Nigeria, stating that the drug’s effectiveness has been established through research and was necessary, especially among persons with multiple partners.
Commenting on the affordability and availability of the rings in Nigeria, the gynaecologist said that the VRs might be expensive at first but could be subsidised through funding from the government and non-governmental organisations.
“It has shown to be 50 per cent effective but they have not been used worldwide. The NGOs are yet to come in so they are a bit expensive but they are not yet available in Nigeria and are only available in East African countries such as Zimbabwe, Kenya, South Africa and countries around that area.
“But when it is brought to Nigeria, it is going to be mostly used by those at risk and as it becomes more available the NGOs can step in to help subsidise the amount or buy it and give it free to people to prevent the spread of HIV.
“Any place where you have people who are at risk, it is a perfect option, especially when it is combined with a condom. I think Nigeria should get it right. When something has just started somewhere, one needs to watch out and see how it is before one quickly grabs it. But the result is coming out, one day, we will see it in Nigeria and publicised among those at risk of contracting the disease,” Abdullahi said.
He noted that the production of the VRs in the country depended on the readiness and ability of the pharmaceutical companies to produce them.
The gynaecologist added that if the production was not possible, it could be imported into the country.
On what Nigeria needs to do to meet the 2030 elimination of AIDS target, the senior medical consultant asserted that prevention rules for the disease must be followed.
“Abstinence means that unmarried persons, persons with unstable partners should not engage in casual sex. Be faithful to one partner and those who cannot do that should use condoms; the correct and persistent use of condoms will prevent a lot of new infections.
“Drugs: those who are at increased risk are those who are to use these rings, there the oral drugs which they can use to prevent new infections and PLWHAs should comply with their drug regimen because when they do, the viral load would be pushed down to undetectable level. As a result, they won’t be able to transmit to other people and prevent transmission to other people,” Abdullahi said.
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