Prioritizing multipurpose prevention technology development and investments using a target product profile

Romano, J.; Manning, Judy; Hemmerling, Anke; McGrory, Elizabeth; Holt, Bethany Young

doi:10.1016/j.antiviral.2013.09.016

Cited by 28 publications

(24 citation statements)

References 28 publications

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“…Multipurpose prevention technologies (MPTs) are an innovative class of products that deliver varied combinations of HIV prevention, other sexually transmitted infection (STI) prevention, and contraception. MPTs that combine HIV prevention and contraceptives in one delivery form offer a strategy to ease user and health systems burden as well as address key barriers to adoption of either biomedical prevention method alone [5, 6]. MPTs may increase adherence by simplifying use and capitalizing on the opportunity to integrate HIV prevention with a less stigmatized indication, pregnancy prevention.…”

Section: Introductionmentioning

confidence: 99%

Young Women’s Ratings of Three Placebo Multipurpose Prevention Technologies for HIV and Pregnancy Prevention in a Randomized, Cross-Over Study in Kenya and South Africa

Minnis

Roberts²,

Agot

et al. 2018

AIDS Behav

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End-user input is critical to inform development of multipurpose prevention technology (MPT) products that prevent HIV and pregnancy. The TRIO Study, conducted in Kenya and South Africa, enrolled 277 HIV-negative women aged 18–30 in a randomized cross-over study to use each placebo MPT (daily oral tablets, monthly injections, and monthly vaginal ring) for one month. At the end of each month, participants rated how much they liked using the product on a 5-point Likert scale (5 = liked very much). We compared mean ratings using paired t-tests and examined sociodemographic-, attribute-, and behavior-related characteristics associated with ratings using multivariable linear regression and data from in-depth interviews. After use, mean ratings were significantly higher for injections [4.3 (SD = 1.0)] compared with tablets [3.0 (SD = 1.3)] and rings [3.3 (SD = 1.4)] (p < 0.001); mean ratings for rings were significantly higher than for tablets (p = 0.013). Mean ratings of a hypothetical active MPT increased for all products after the one-month period of use, with the greatest increase for rings, the least familiar product. In multivariable analysis, acceptability of key product attributes (e.g., product look) were associated with a significant increase of ≥ 1 point in the mean rating across all three products (p ≤ 0.001). Perceived ability to use the product without partner knowledge was associated with a higher mean rating for rings (b = 0.50; p = 0.006). The acceptability of product attributes contributed significantly to the rating of all products, highlighting the value of choice in pregnancy and HIV prevention to accommodate diverse users.

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Section: Introductionmentioning

confidence: 99%

Young Women’s Ratings of Three Placebo Multipurpose Prevention Technologies for HIV and Pregnancy Prevention in a Randomized, Cross-Over Study in Kenya and South Africa

Minnis

Roberts²,

Agot

et al. 2018

AIDS Behav

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“…The underlying mechanisms are not yet established, although in vitro and animal studies indicate that DMPA may have pleiotropic effects including thinning of the epithelial barrier, alterations in the vaginal microbiome, and immunomodulatory effects 5 . Concerns about DMPA have fostered the design of multipurpose IVRs to deliver antiretroviral drugs in combination with levonorgestrol or other hormonal contraceptives 6, 7 .…”

Section: Introductionmentioning

confidence: 99%

Tenofovir Disoproxil Fumarate Intravaginal Ring Protects High-Dose Depot Medroxyprogesterone Acetate–Treated Macaques From Multiple SHIV Exposures

Smith

Srinivasan

Teller

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Preclinical HIV prevention models use either a single high-dose viral challenge in depot medroxyprogesterone acetate (DMPA)-treated macaques or repeated viral challenges in cycling macaques. We tested the efficacy of an intravaginal tenofovir disoproxil fumarate (TDF) ring in a model combining repeated 30 mg injections of DMPA every 6 weeks with vaginal viral challenges weekly for 12 weeks. Twelve macaques were randomized to TDF or placebo rings. All placebo macaques became infected after a median of 2 exposures, whereas only one TDF macaque became infected at the eighth exposure (p=0.0012). The TDF ring provides durable protection in a stringent challenge model.

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“…MPT development has concentrated on establishing a desired ‘Target Product Profile’ to guide product development, but this focus has so far not included appreciable considerations of users’ preferences and product acceptability, and as a result, such information is quite limited . The only MPT currently available for women is the female condom.…”

Section: Introductionmentioning

confidence: 99%

Interest in multipurpose prevention of HIV and pregnancy: perspectives of women, men, health professionals and community stakeholders in two vaginal gel studies in southern Africa

Woodsong

Musara

Chandipwisa

et al. 2014

BJOG

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Objective The pipeline of vaginal microbicides for HIV prevention has expanded to include products for multipurpose prevention, but the interests of potential users and those advising on use have not been sufficiently investigated. Rather, assumptions about interest in multipurpose prevention technologies (MPTs) are inferred from what is known about acceptability and use of microbicides or contraceptives.Design and setting This paper presents data on concerns and preferences for multipurpose prevention of HIV and pregnancy. Data were collected in two microbicide gel studies in Malawi and Zimbabwe. Participants were women using candidate vaginal products, their male partners, health professionals and community stakeholders.Methods An individual interview was conducted with participants. Interviews were audio-recorded, transcribed, coded for content and analysed for key themes.Results Participants indicated strong interest in a vaginal HIV prevention product that could also prevent pregnancy. Reasons for this interest were convenience, problems with adverse effects with current contraceptive methods, concerns about long-term effects of contraceptives, and concerns about the health burdens of HIV infection during pregnancy. The main disadvantage of an MPT was recognition that while interest in preventing HIV is constant, contraceptive needs change over time.Conclusion The study population indicated support for an MPT to prevent HIV and pregnancy. This support may be further strengthened if the product is also available for prevention of only HIV. Women and men will be more willing to use an MPT if they can be reassured that its use will have no long-term effect on fertility.

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Prioritizing multipurpose prevention technology development and investments using a target product profile

Cited by 28 publications

References 28 publications

Young Women’s Ratings of Three Placebo Multipurpose Prevention Technologies for HIV and Pregnancy Prevention in a Randomized, Cross-Over Study in Kenya and South Africa

Young Women’s Ratings of Three Placebo Multipurpose Prevention Technologies for HIV and Pregnancy Prevention in a Randomized, Cross-Over Study in Kenya and South Africa

Tenofovir Disoproxil Fumarate Intravaginal Ring Protects High-Dose Depot Medroxyprogesterone Acetate–Treated Macaques From Multiple SHIV Exposures

Interest in multipurpose prevention of HIV and pregnancy: perspectives of women, men, health professionals and community stakeholders in two vaginal gel studies in southern Africa

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