FROM THE PIPELINE | A long-acting multipurpose prevention ring to help protect against HIV and unintended pregnancy
Published: March 13, 2018
Leveraging its experience developing the first vaginal ring and long-acting product shown to help prevent HIV, the nonprofit International Partnership for Microbicides is now developing a three-month vaginal ring designed to reduce women’s HIV risk and prevent unplanned pregnancy. This innovative multipurpose prevention technology would offer women a discreet option to protect their sexual and reproductive health on their own terms.
“Young women are more worried about being pregnant. But HIV is dangerous. We need dual protection.” – Young woman at HIV prevention forum
Time and again, we at the International Partnership for Microbicides (IPM) hear women ask for MPTs they can use to protect their sexual and reproductive health.
It’s easy to see why: across the globe, a woman between the ages of 15 and 44 is most likely to die from causes related to HIV/AIDS or from complications related to pregnancy and childbirth. And women often face dual risks, because areas with high rates of HIV also have high unmet contraceptive need. In Sub-Saharan Africa—where women carry nearly 60 percent of the HIV burden and young women are at least twice as likely to become infected as young men—21 percent of women want, but lack access to, modern contraceptive methods.
Advancing new solutions: The dapivirine-contraceptive ring
Although existing MPTs like male and female condoms are highly effective when used, it’s not always possible for women to negotiate condom use with their partners. That’s why IPM is prioritizing the development of a new option that women could use discreetly: a three-month vaginal ring designed to offer simultaneous protection against HIV and unintended pregnancy.
Leveraging our experience developing a one-month HIV prevention vaginal ring, which has been clinically shown to safely help reduce women’s HIV risk, the MPT ring combines the antiretroviral drug dapivirine with the contraceptive hormone levonorgestrel. Women would insert the ring themselves and replace it every three months.
Last year, the dapivirine-contraceptive ring moved into its first clinical trial to assess the ring’s safety and pharmacokinetics, or how the body processes the two drugs, and to explore product acceptability. The study is being conducted by IPM’s partner, the Microbicide Trials Network, among 24 women at two sites in the United States. We expect to have results later in 2018, which will help us determine the next steps for the product’s development.
The dapivirine-contraceptive ring would be the first product of its kind, providing women with a self-initiated, long-acting dual-purpose prevention option they can control on their own terms. The more options women have, the more likely they are to find one they can use.
The promise of MPTs
A long-acting innovation like the dapivirine-contraceptive ring offers greater convenience, requires fewer clinic visits, and may reduce the stigma associated with HIV services because MPTs would likely be delivered through family planning services. MPTs may also draw wide interest—both from women who prioritize reducing their HIV risk and women with high perceived risk for unintended pregnancy, as the opening quote suggests.
MPTs are part of IPM’s mission to develop and make available new HIV prevention and sexual and reproductive health technologies for women. In addition to the one-month dapivirine ring now under regulatory review, IPM’s pipeline includes other products designed to help increase efficacy against HIV, such as a three-month dapivirine-only ring and combination products that contain multiple ARVs.
At IPM, we are working toward a world where women can thrive and reach their full potential because they have the range of products they need to protect their sexual and reproductive health. MPTs are essential to realizing that vision, because investing in women’s well-being is an investment in better health and economic outcomes for families and communities.
 “Women’s health.” World Health Organization, September 2013. http://www.who.int/mediacentre/factsheets/fs334/en/, accessed Feb. 26, 2018.
 UNAIDS, AIDSinfo database. http://aidsinfo.unaids.org, accessed Feb. 26, 2018.
 Guttmacher Institute. “Adding It Up: Investing in Contraception and Maternal and Newborn Health, 2017.” 2017.
- A Multipurpose Prevention Ring for Women’s Sexual and Reproductive Health (fact sheet)
- New Technologies for Women’s HIV Prevention: The Payoff for Sustainable Development