Global rates of HIV incidence and unintended pregnancy remain high. Almost 50% of the 121 million annual pregnancies worldwide are unintended (United Nations, 2022), and sexually transmitted diseases continue to be heavily stigmatized. Multipurpose prevention technologies (MPT) have the potential to transform the way clinicians and researchers approach HIV and pregnancy prevention. These products offer an approach that addresses multiple aspects of women’s health in a convenient, discretionary, reversible, accessible, and cost-effective manner.

In a recent Phase 1 Trial conducted through the Microbicide Trials Network and the Contraceptive Clinical Trials Network, researchers from RTI International’s Women’s Global Health Imperative explored the experiences of participants using a 3-month vaginal ring for HIV and pregnancy prevention. The study included 25 participants with half using the vaginal ring in 28-day cycles with 2-day removal periods and half using the vaginal ring continuously for 90 days. At the end of their participation, all participants completed in-depth interviews to share their experience with the vaginal ring. Although the ring was well tolerated, participants encountered challenges with ring slippage, expulsions, side effects, and changes in vaginal bleeding. With these challenges, some participants expressed disinterest but stated they would be encouraged to use the ring if these challenges were to be mitigated or if they had a higher risk for HIV or pregnancy.

By actively involving participants and considering their perspectives, researchers can better align the vaginal ring with the users needs, preferences, and lifestyle. A user-centered approach allows researchers to identify aspects of a prevention product that would be seen as a value-add for users such as allowing for greater autonomy, “beneficial” side effects (like lighter/shorter menstrual bleeding), and multiple indications. Focusing on these aspects provides the opportunity to shift the field away from risk-based approaches to prevention, and towards strategies that emphasize user benefits and desirability. This, in turn, seeks to promote higher adherence and adoption in larger-scale settings. You can read more about this study here: Participant experiences with a multipurpose vaginal ring for HIV and pregnancy prevention during a phase 1 clinical trial: learning from users to improve acceptability.

This project was funded by the National Institute of Child Health and Human Development (NICHD) Contraceptive Development Program and the Microbicide Trial Network (MTN).