Intravaginal Ring Being Tested To Deliver Antiretroviral Medication For HIV Prevention

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Preventive antiretroviral medications for HIV could, in the future, come in the form of an intravaginal ring for women.

A new study from Northwestern University shows that intravaginal rings were 100 percent effective in protecting simian immunodeficiency virus in monkeys. The device will now be tested in humans in a trial at the Albert Einstein College of Medicine, in which 60 women will test the ring for 14 days.

"After 10 years of work, we have created an intravaginal ring that can prevent against multiple HIV exposures ^[1] over an extended period of time, with consistent prevention levels throughout the menstrual cycle," study researcher Patrick Kiser, of Northwestern University, said in a statement.

Kiser, who conducted the research while at the University of Utah, noted that this could be a good preventive option considering the tediousness of taking high-dose pills daily, and usage rates are poor for vaginal gels because they must be applied before sex. The ring, which contains a powdered version of the antiretroviral tenofovir, works by being inserted for 30 days at a time (tenofovir is already taken orally as an antiretroviral).

However, the ring is different from current intravaginal devices ^[2] , such as the NuvaRing for contraception, because its made with unique polymers that can release more of the drug at a time, compared with silicone.

The study is published in the journal Proceedings of the National Academy of Sciences ^[3] .

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1. Most Don't Have Their Infection Under Control

Only one quarter of the 1.1 million <a href="http://www.cdc.gov/nchhstp/newsroom/docs/2012/Stages-of-CareFactSheet-508.pdf">people with HIV</a> have their <a href="http://www.huffingtonpost.com/2012/07/27/hiv-under-control-1-in-4_n_1711260.html">condition under control</a>, where "under control" means the virus has been suppressed, according to a report released this summer by the Centers for Disease Control and Prevention. "Only if we get <a href="http://www.philly.com/philly/health/HealthDay667108_20120727_Only_1_in_4_Americans_With_HIV_Has_Virus_Under_Control__CDC.html">everyone under regular care</a> for HIV/AIDS can we recognize the full benefits of treatment and prevention," Irene Hall, an epidemiologist at the CDC and one of the authors of the report, told HealthDay. CORRECTION: The first sentence has been reworded to more accurately reflect the number of people with HIV.

2. Bone Marrow Transplants Could Play A Part In Being HIV-Free

Two men with HIV and cancer no longer have <a href="http://www.huffingtonpost.com/2012/07/26/hiv-free-men-bone-marrow-transplants_n_1707505.html">detectable blood levels of the virus</a> after receiving bone marrow transplants for their cancers, news outlets reported this year. Doctors were unable to <a href="http://www.huffingtonpost.com/2012/07/26/hiv-free-men-bone-marrow-transplants_n_1707505.html">find any traces of HIV</a> in the men's cells after they received the bone marrow transplants while also being treated with antiretrovirals. The finding "suggests that under the <a href="http://abcnews.go.com/blogs/health/2012/07/26/two-more-patients-hiv-free-after-bone-marrow-transplants/">cover of anti-retroviral therapy</a>, the cells that repopulated the patient's immune system appear to be protected from becoming re-infected with HIV," Dr. Timothy Henrich, of Brigham and Women's Hospital, told ABC News. However, the Boston Globe pointed out that it's still too soon to say that these men have been<a href="http://www.huffingtonpost.com/2012/07/26/hiv-free-men-bone-marrow-transplants_n_1707505.html"> full-on cured</a> of HIV, since they are still on the anti-retrovirals. There's no firm word on whether they will go off of the medication.

3. No-Cost HIV Treatment Could Cut New Infection Rates

New <a href="http://www.huffingtonpost.ca/2012/11/27/free-hiv-drugs-decrease-infection-bc_n_2200393.html">HIV infection rates</a> can be dramatically lowered by making antiretroviral drugs free, a study from Canadian researchers found. The Canadian Press reported on the study, conducted by B.C. Centre for Excellence in HIV-AIDS researchers, which showed that British Columbia -- a province that offers <a href="http://www.huffingtonpost.ca/2012/11/27/free-hiv-drugs-decrease-infection-bc_n_2200393.html">free access to antiretroviral therapy</a> -- had the lowest rate of new HIV infections over a more-than-10-year period, compared with Ontairio and Quebec.

4. Many Young People Don't Know Their HIV Status

More than half of HIV-infected young people are <a href="http://www.huffingtonpost.com/2012/11/27/hiv-youths-infected-aids-young-people_n_2198629.html">unaware that they have the virus</a>, according to a Centers for Disease Control and Prevention report. "Given everything we know about HIV and how to prevent it in 30 years of fighting the disease, it's just unacceptable that young people are <a href="http://www.huffingtonpost.com/2012/11/27/hiv-youths-infected-aids-young-people_n_2198629.html">becoming infected at such high rates</a>," Reuters reported CDC Director Dr. Thomas Frieden saying. The report also showed that for young people, 72 percent of the new HIV infections were in men who have sex with men, while almost 50 percent were in young, African-American males, Reuters reported. These figures are based on 2010 data.

5. More People Are Living With HIV Than 10 Years Ago

The number of people <a href="http://www.huffingtonpost.com/2012/07/18/hiv-aids-numbers-statistics-worldwide_n_1682936.html">living with HIV</a> has increased by 18 percent from 2001 to 2011, according to a report released this year from the United Nations Programme on AIDS. An estimated 34.2 million people around the world are living with HIV. The report also showed that <a href="http://www.huffingtonpost.com/2012/07/18/hiv-aids-numbers-statistics-worldwide_n_1682936.html">deaths from AIDS </a>have dropped, from 2.3 million in 2005-2006 to 1.7 million in 2011, Reuters reported.

6. The Cost Of HIV Drugs Is Decreasing

According to the same United Nations report, costs for the cheapest UN-recommended <a href="http://www.huffingtonpost.com/2012/07/18/hiv-aids-numbers-statistics-worldwide_n_1682936.html">antiretroviral therapy drugs</a> have also decreased over the past 10 years, Reuters reported. A year's worth of the drugs used to cost $10,000 in 2000 for one person; now, it costs $100 a year.

7. HIV Treatment Truvada Can Also Be Used As A Preventive Measure

The Food and Drug Administration this year officially approved the <a href="http://www.huffingtonpost.com/2012/08/09/truvada-heterosexuals-aids-hiv-prevention-pill_n_1760542.html">drug Truvada</a> -- which has been used since 2004 as a treatment for HIV -- to be sold as a preventive measure for people who don't have the infection, but are at high risk for it. The FDA said that the pill should be considered for <a href="http://www.huffingtonpost.com/2012/08/09/truvada-heterosexuals-aids-hiv-prevention-pill_n_1760542.html">preventive use</a> not only by gay or bisexual men who are at high risk for HIV, but also heterosexual men and women who may also face HIV risks, the Associated Press reported. <a href="http://www.huffingtonpost.com/2012/08/09/truvada-heterosexuals-aids-hiv-prevention-pill_n_1760542.html">Heterosexual men and women</a> make up more than one-fourth of new cases of HIV, and "that's not a portion of the epidemic we want to ignore," the CDC's Dr. Dawn Smith, who was the lead author of the new recommendations, told the Associated Press. The FDA also approved a new drug this year, <a href="http://www.huffingtonpost.com/2012/08/27/stribild-hiv-treatment-fda_n_1834734.html">Stribild</a>, to treat HIV, Reuters reported.

8. Engineered Stem Cells Could Play A Part In Fighting HIV

In findings published this year in the journal PLoS Pathogens, scientists from the University of California, Los Angeles found that it's possible to <a href="http://www.huffingtonpost.com/2012/04/16/stem-cell-aids-hiv-study-ucla_n_1428660.html">genetically engineer stem cells</a> to attack living HIV-infected cells in mice. While the study was only for "proof-of-principle," it "lays the groundwork for the potential use of this type of an approach in combating HIV infection in infected individuals, in hopes of eradicating the virus from the body," study researcher Dr. Scott G. Kitchen, an assistant professor of medicine at UCLA, said in a statement.

9. Pretty Much Everyone Should Be Screened For HIV

People should be screened for HIV even if they're not at high risk of contracting the infection, according to draft recommendations released just last month by the U.S. Preventive Services Task Force. The recommendations would mean that everyone between the ages of 15 and 65 should be <a href="http://www.huffingtonpost.com/2012/11/19/routine-hiv-screening-us-preventive-services-task-force-uspstf_n_2161090.html">screened for HIV</a>, even if they're not at high risk for it, Reuters reported. "The prior recommendations were for screening high-risk adults and adolescents," Dr. Douglas Owens, a member of the USPSTF task force and a Stanford University medical professor, told Reuters. "The current recommendation is for <a href="http://www.huffingtonpost.com/2012/11/19/routine-hiv-screening-us-preventive-services-task-force-uspstf_n_2161090.html">screening everyone</a>, regardless of their risk."

10. People Should Be Treated With Antiretrovirals As Soon As They're Diagnosed WIth HIV

All HIV patients should be <a href="http://healthland.time.com/2012/07/23/new-advice-calls-for-putting-all-hiv-patients-on-drug-treatment/">treated immediately with antiretrovirals</a>, according to new guidelines issued this year from a panel of the International Antiviral Society-USA, as reported by TIME. The recommendations are counter to previous guidelines, which said that antiretrovirals should only be used if the CD4 count -- a measure of immune cells in a person's body -- becomes less than 350 cells for every mm3 of blood.