The Start of REACH and Other MTN Milestones
February 7, 2019
Dear MTN Friends and Family
We are writing today to share the exciting news about the launch of the REACH study (MTN-034) and to update you on the progress we are making with other studies in the MTN.
The HOPE study, which provided former ASPIRE study participants a chance to use the dapivirine ring for a year, has recently concluded. Data analysis is underway, but certain things are clear, even without tables and graphs. Adherence to ring use was higher than was observed in the APSIRE study – not surprising since women knew that the ring could reduce their risk of HIV. But we also learned that many women were very satisfied with the ring and that they are eager to access this product if and when it becomes available. Our partners at the International Partnership for Microbicides are working hard to ensure that the dream of having a safe, woman-controlled topical product for prevention of HIV will become a reality.
But what about young women? REACH, a study of 300 young women ages 16-21, was just launched in Kampala, Uganda yesterday and we are very excited about what this study will teach us. Young women have struggled with adherence to both daily oral PrEP and the vaginal ring in clinical trials of these products. REACH, which will be conducted in Kenya, South Africa, and Zimbabwe, in addition to Uganda, will be different from other studies in that young women will experience six months of both oral PrEP and dapivirine ring use, and then have an opportunity to choose the product they most liked for a final six-month period. This unique design will allow young women to try out both forms of PrEP (pills and the ring) and will thus allow us to really better understand the challenges young women face incorporating these new prevention options into their complicated adolescent lives.
We are also in the final stages of preparing protocols for the evaluation of the dapivirine ring and oral PrEP in 750 pregnant women in a study called DELIVER (MTN-042) and 200 breastfeeding women in a study called B-PROTECTED (MTN-043). At the same time, we are completing two studies of 90-day vaginal rings, one containing dapivirine (MTN-036) and one containing tenofovir (MTN-038). Another study, of the multipurpose dapivirine ring with a contraceptive (MTN-044), is 50% enrolled. We are making headway with our rectal studies agenda as well, which includes a study of dapivirine gel used as a lube (MTN-033), a multipurpose gel active against HIV and STIs (MTN-037), and a new study called DESIRE (MTN-035) which is about to be launched and will provide new information on how MSM, trans men and trans women in Malawi Peru, South Africa, Thailand, and the US view rectal douches, rectal inserts and suppositories as options for on-demand HIV prevention.
This is an incredibly exciting time to be working on topical options for HIV prevention – working hard so that women and men around the world have choices that work in their lives. We want to thank our many collaborators around the world, our partners at CONRAD, Gilead, IPM, and the Population Council and our funders at NIAID, NICHD and NIMH for their support of this work. We also want to thank the many investigators in the MTN family for their support of this research.
All the best in this important, meaningful work,
Sharon and Jared