Systematic review shows vaginal rings acceptable among women in low- and mid-income countries
RESEARCH TRIANGLE PARK, N.C. — A systematic review of vaginal ring acceptability and related preferences in low- and middle-income countries conducted by RTI International, a nonprofit research institute, found that vaginal ring acceptability was high among women ranging from 71-98 percent in randomized controlled trials and from 62-100 percent in observational studies.
“The acceptability of vaginal rings as preventive methods is extremely encouraging,” says Jennifer Griffin, a research epidemiologist at RTI and primary author of the review. “Women who find a method acceptable are more likely to use it consistently and correctly, which could help women prevent unplanned pregnancies and HIV infection.”
Every year approximately 14 million unintended pregnancies occur in sub-Saharan Africa. Women in Africa are also disproportionally impacted by HIV, with greater than three times the prevalence of men in some countries. Unintended pregnancies and HIV are major contributors to women’s morbidity and mortality in these settings. Given this high double burden, female-initiated methods are critical to prevent unintended pregnancy, HIV, or both.
The systematic review looked at acceptability of the vaginal ring among women in low- and middle-income countries, considering vaginal ring use for contraception, HIV prevention, menopause symptom management and other indications. Measures of acceptability tended to improve over chronological time, as the method was popularized, as well as during study follow-up, as women gained experience with the vaginal ring.
Vaginal rings are long-acting, drug-delivery products that work by slowly releasing drugs into the inner lining of the vagina. RTI’s systematic review found that women expressed preferences for accessible, long-acting, partner-approved, effective methods that prevent both HIV and pregnancy, can be used without partner knowledge, and have no impact on sex and few side effects.
The team is currently conducting an analysis of vaginal ring acceptability in high-income countries and expect these results to be published in 2020.
The full results of this review were published in the November issue of PLOS. Click here to read the full paper.