Making Broad-Spectrum Sexual & Reproductive Health Prevention A Reality Through Collaboration
This guest post was written by Bethany Young Holt, PhD, MPH
Imagine the global health impact if women who want to prevent a pregnancy had contraception that also prevented sexually transmitted infection (STIs) including HIV. Not only would such products expand prevention options for women, they would simultaneously help reduce a myriad of related risks, including maternal mortality and morbidity, adolescent sexual and reproductive health (SRH) risks, under 5 mortality, cancers and infertility resulting from untreated STIs, and the human, economic and treatment costs of declining health from HIV/AIDS.
Multipurpose Prevention Technologies (MPTs) are products on the horizon that offer broad-spectrum SRH prevention. They promise to be a game-changer for women’s health around the world. A growing collaboration of researchers, women’s health advocates and funders from across the globe is shaping this field and making an array of comprehensive options a reality.
MPT Potential Impact
Today, if women want to protect themselves from unintended pregnancies and STIs, condoms are the only option for “all-of-the-above” prevention. Both male and female condoms require male partner cooperation. While condoms are extremely effective if used consistently and correctly, couples overwhelmingly forgo them once they are in a more committed partnership. In fact, only 8 percent of committed couples world-wide use condoms, leaving millions of women who use alternative kinds of birth control in danger of contracting HIV and other STIs.
Furthermore, there are many millions of women worldwide who want to avoid or delay having children but lack access to modern contraceptive methods—increasing their chances of unplanned pregnancy or, depending on the contraceptives available, STI infection.
Women agree, it is clearly time to create new, female-initiated products that offer multipurpose prevention of HIV, other STIs, and unintended pregnancy. Recently, researchers at Ipsos Healthcare released a study finding that ninety-three percent of women interviewed in Uganda, Nigeria, and South Africa who were given a hypothetical choice of methods preferred the one that offered broad spectrum prevention rather than simply an HIV prevention tool or a contraceptive.
Women’s lives are complex and their circumstances vary considerably; no single broad-spectrum product will meet most women’s needs. Rather than promoting a single method, researchers and advocates are advancing an array or suite of combination prevention methods so that women can find methods that suit their lives.
With MPTs in women’s hands, we can expect a decline in HIV rates in high-risk regions as preventing STIs becomes easier and prevention more accessible. In addition, we can expect reductions in the 86 million unplanned pregnancies worldwide and improvements in maternal mortality and morbidity.
When contraceptive efficacy increases, so does the quality of life for women and children: As women are better able to plan their children and stay healthy, they are more likely to attain higher levels of education and economic stability.
Women’s Input at the Heart of MPT Development
The development of MPTs has required a number of innovations that are made possible through an international collaboration of researchers, policymakers, and advocates known as the Initiative for MPTs (IMPT). To date the Initiative has succeeded in transcending a number of barriers to innovation, not the least of which are the silos traditionally separating HIV, contraceptive, and STI research. Until recently, funding for each of these fields, primarily from the governmental sectors and private foundations, was separate and disconnected—a great challenge for collaboration.
Through the collaborative structure of the IMPT, stakeholders are working together, some for the first time, to share findings, reduce redundancies, and create a more streamlined and efficient field. Noteworthy advances can be viewed in the MPT product development database, for example, where anyone can find details about products currently in development.
This work is putting women’s feedback at the heart of product development. Scientists, as they develop new products, traditionally have not sought women’s opinions and feedback until later-stage clinical trials. The IMPT is changing the funding priorities so that women’s input on acceptability and uptake issues is sought at the get-go and social-behavioral research that informs whether women will actually use a given product is meaningfully integrated into the biomedical research.
The progress made to date in the MPT field, in combination with the potential cost savings and efficiencies offered by MPTs, makes for a compelling case for funding innovation and the international collaboration approach. We invite readers whose work intersects with that of the IMPT to contact us to explore involvement.
Bethany Young Holt, PhD, MPH is the Executive Director of CAMI Health, a project of PHI, and Coordinator of the IMPT (Initiative for Multipurpose Prevention Technologies)