African women in a study of a vaginal ring used as pre-exposure prophylaxis (PrEP) for the most part said wearing the ring did not affect the physical act of sex. However, for some the worry that their partner would discover they were using the ring reduced the enjoyment of sex. Also, the few women who were burdened by intimate partner violence were much less likely to use the ring.

At the HIV Research for Prevention (HIVR4P) meeting in Chicago, researchers presented new findings from the MTN-020 study, also known as ASPIRE, of a dapivirine-containing vaginal ring studied as PrEP among 2,629 women 18 to 45 years old in Malawi, South Africa, Uganda and Zimbabwe.

Study results presented at the 21st International AIDS Conference in Durban, South Africa (AIDS 2016), in July showed that on the whole, giving the ring to women reduced their risk of HIV by 27 percent. Women who used the ring with greater frequency had a 56 percent reduced risk, and those who used it consistently had a 75 percent reduced risk of HIV.

To reach the new findings, the researchers interviewed 214 participants who used the ring about their qualitative experiences with it. Most said the ring did not affect the physical act of sex negatively.

However, some women said they fixated on how their male partners would react if they found out about the ring. Consequently, some of them removed the ring before sex, which is not recommended. Others curtailed certain sexual practices they thought would raise the risk of the man finding the ring, including particular sexual positions and receptive oral or digital sex.

Some women reported having greater sexual satisfaction because they believed the ring was protecting them against HIV. But others had the opposite experience because of their worries over their male partners discovering the ring.

Less than 5 percent of the women said they experienced intimate partner-related violence or other related social harms. Those who did were nearly two and a half times more likely to adhere poorly to the ring’s protocol for use (the women received instructions to leave each ring in for a month).

Sixty-four percent of the women told their male partners they were using the ring at the beginning of the study. Thirteen percent never disclosed their use of the ring to their partners.

To read a press release about the study, click here.