New technologies currently under development that can simultaneously prevent pregnancy as well as protect against HIV and other sexually transmitted infections (STIs) have the potential to greatly improve women’s sexual and reproductive health globally, according to "Making the Case for Multipurpose Technologies: The Socio-Epidemiological Rationale," by Heather Boonstra and Sneha Barot of the Guttmacher Institute and Manjula Lusti-Narasimhan of the World Health Organization. The article, published in BJOG: An International Journal of Obstetrics and Gynaecology, outlines the advantages of multipurpose prevention technologies (MPTs) and discusses challenges that need to be addressed to ensure successful introduction of these methods.
"The evidence strongly indicates that providing women with effective new tools to simultaneously prevent unwanted pregnancy as well as protect against STIs and HIV is essential," says lead author Heather Boonstra. "However, just developing these methods is not enough. They need to be designed and marketed in a way that meets the needs and respects the rights of women and their partners. Ultimately, MPTs will only be viable options if women actually use them."
Male and female condoms are currently the only methods that provide dual protection against pregnancy and STIs. Several MPTs in development could significantly expand women’s options to protect themselves. They include:
- a gel shown to be effective against HIV and the herpes simplex virus;
- a vaginal ring containing antiretroviral compounds for the prevention of unintended pregnancy and HIV infection;
- and a new one-size-fits-all diaphragm that prevents pregnancy, which could be combined with drugs to prevent HIV infection.
According to the report, the need for MPTs is urgent and well documented, with large numbers of women at risk for unintended pregnancy as well as HIV and other STIs:
- In developing countries, women with unmet need for modern contraception account for 79% of unintended pregnancies.
- More than 104 million women in Sub-Saharan Africa, South Central Asia and Southeast Asia don’t use modern contraceptives because of fears about health risks and adverse effects as well as other concerns.
- Globally, women comprise 50% of people living with HIV but women are disproportionately affected in some high-prevalence countries. HIV is now the leading cause of death among women of reproductive age.
- Left undetected and untreated, the human papillomavirus (HPV) may lead to cervical cancer, the second leading cause of cancer deaths among women in developing countries.
"To succeed, MPTs must adequately address concerns that cause many women to reject other modern contraceptive methods, taking into account women’s perceptions of risk for unintended pregnancy, HIV and other STIs," says Boonstra. "Any successful strategy must also acknowledge that women’s needs change over time, and a suite of MPT options may be needed to provide women with choices."
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Video: MPTs for a Better World