By Tobore Ovuorie
Better days are ahead for women globally as the World Health Organization (WHO) has recommended a vaginal ring; which can prevent the contracting of HIV, to be added as a prevention choice for women who are substantially at risk of the virus.
This was disclosed Thursday, at the HIVR4P virtual conference by Michelle Rodolph of the WHO, while addressing the 2021 HIVR4P media Fellows.
The ring, Ms. Rodolph said would be offered as a choice preventive like other contraceptives.
The WHO guideline is a critical step for having HIV prevention choices for women and this is considered a win by Ms. Chilufya Kasanda, Programmes Officer, Treatment Advocacy and Literacy Campaign (TALC) Lusaka, Zambia.
“Many women in Africa for a long time have lacked options which they can control. Thus, the ring empowers women to make better choices as they continue to be affected by HIV,” she said.
Global statistics indicates that the global burden of HIV falls on women in sub-Sahara Africa as no fewer than 60 percent of all new adult infections are among women.
“This is why they urgently need and deserve more choices for HIV prevention,” says International Partnership for Microbicides (IPM); inventors of the ring, in one of the firm’s videos about the product.
Dapivirine Vaginal Ring
Made of silicon, the ring, when set near the cervix in the vagina, releases an antiretroviral called dapivirine at the sight of potential infections and blocks the virus.
A ring is to be set in the vagina; near the cervix every month and wouldn’t need to be removed during menstruation or sexual intercourse, as it cannot be felt.
The IPM says the long-acting vaginal ring for HIV prevention reduces HIV risk by 50 percent and should be used with either male or female condoms.
The ring would last for 28 days in the vagina before a replacement is needed. Reproductive and Sexual Health experts say it would save on time, cost and give a sense of security.
“Because if raped, a woman wearing the ring is protected from contracting HIV. It is better having a ring inside of me than nothing else for protection,” the HIV prevention advocate; Ms. Chilufya said.
Ms. Chilufya explained that the ring is a long-acting choice many women in Africa have longed for and is very discreet, so, can be used without a partner’s permission.
Many times, women don’t have a choice when it comes to HIV prevention because most options require reaching a compromise with their partners except for PrEp (pre-exposure prophylaxis) – an oral option.
With the ring, this is different as there is a privacy that goes with the ring because no one will be able to tell when inserted in the vagina unlike the oral PrEp which doesn’t provide such privacy.
Ms. Chilufya emphasized that the ring is a great solution for women who are presently experiencing Gender Based Violence (GBV) due to the COVID-19.
Studies so far reveal that though quarantine is a necessary and major way to reduce the COVID-19 spread, it has birthed serious psychological and socially disruptive consequences including a surge in the cases of gender violence within many families and homes.
Nigerians Welcome Product With Mixed Reactions
The ring which is yet to arrive sub-Sahara Africa already has several challenges awaiting its arrival in Nigeria.
In an online survey which this reporter started conducting via various social media outlets immediately after the media brief ended, cultural and religious beliefs and practices topped the list of major barriers awaiting the ring’s arrival in Nigeria.
Apostle Chibuzor Ofoegbu, a clergy with the Eternal Sacred Order of Cherubim and Seraphim in Lagos, South-West Nigeria said he will discourage his wife from using the vaginal ring and would be mad at her if he discovers she is using it without first telling him. He said he doesn’t like a vaginal ring.
Dr. Ezinne Ezepue, a lecturer at the Theatre and Film Studies Department of the University of Nigeria, Nsukka, said she would not use the vaginal ring because she doesn’t feel threatened and so has no need to protect herself.
She however added: “I know someone who would very much love to use the product but she doesn’t use a smart phone and so cannot respond (to the reporter’s survey). I would like to gift her one just for her to protect herself.”
Mr. Joseph Okoghenun a Public Relations professional in Lagos, said “It is her body.
“Whatever she does with it that doesn’t affect my and her health and socio-economic wellbeing negatively, is welcome by me.
“But I hope feminists won’t raise eyebrows when masculinity advocates start criticizing this secrecy.”
Ms. Rita Akpojaroh an educationist and entrepreneur said she will not use the vaginal ring because it is unnecessary for her to.
“I am 100 percent sure I am my husband’s only sexual partner and he is mine, as well.”
But Ms. Justina Auta, a journalist in Nigeria’s Federal Capital Territory, said she will use the vaginal ring not because she doesn’t trust her partner but to further protect herself from contracting HIV in view of the increasing cases of sexual violence in the Nigerian society.
“Women and girls are being raped by known and unknown persons,” she emphasized.
Ms. Temple Ajilola, an aAbuja-based journalist said she would not use the vaginal ring except she gets more information about it with full details about the side effects.
Samuel Okolo, a spoken-word poet says he wouldn’t encourage his partner to use the ring and will frown at her using it without informing him before commencing.
“I wouldn’t encourage her on religious and spiritual ground of upholding celibacy,” he explained.
Mr. Ireho Aito, a Lagos-based radio journalist says he will encourage his partner to use the vaginal ring and would have no hard feelings towards her should she commence usage without informing him.
A relationship coach who chooses to be anonymous pleaded that the vaginal ring should be made available in Nigeria immediately.
“Anything that will save lives is welcome by me. If this will prevent infection, then there is hope,” he said.
Mr. Ben Pemii, a Port-Harcourt based independent journalist and author in South-South Nigeria said
“Given the superabundance of conspiracy theories, the use of this ring needs to be further subjected to detailed examination to ensure there are no side effects. I would use it if I were a female.
“But if I’m sure that I’m negative, then there is no need to encourage my partner to use it. I’ll encourage a partner to use it in a situation where the male partner is sexually reckless.
“My finding out that my partner uses the ring without my knowledge won’t carry any serious reaction though I would be surprised,”
Cultural beliefs and practices have been identified as major challenges ahead of the acceptance of the ring in Africa because women in many African communities like in some parts of Nigeria, are not allowed to put anything in their vagina especially in communities with high stakes for feminine virginity.
Ms. Chilufya recommends breaking down the science of and around the ring to local languages. She enjoins all HIV prevention advocates and the media to work together to ensure a seamless and better awareness creation about the vaginal ring so that more women particularly in Africa will make better choices and live healthier lives.
Addressing the fears of possible side effects, Ms. Rodolph explained that the product stops working three hours after removing the ring from the vagina.
“So, if a woman feels she is having side effects, she can remove it.”
Ms. Rodolph said the ring will cost about seven or eight dollars but as production increases, the price too will reduce.
She hinted that donors are looking at getting onboard so it will get to women for free.