title: Multipurpose prevention technologies: products in development.
abstract: Multipurpose prevention technologies (MPTs) are broadly defined as products capable of simultaneously addressing multiple sexual and reproductive health needs including unintended pregnancy, STIs including HIV-1, and other reproductive tract infections. MPTs have been discussed for a few decades but little product development has occurred. With the recent proof-of-concept that a topically applied antiretroviral (ARV) can effectively reduce sexual transmission of HIV-1 (tenofovir 1% gel) the impetus to develop MPTs is gaining momentum. Products currently in development are broadly categorized as either long-acting or on-demand. Long-acting MPTs include intravaginal rings (IVRs) and long-acting injectable products. Several IVR MPTs are under development including one designed to release tenofovir to prevent transmission of HIV-1 and levonorgestrel (LNG) to prevent unintended pregnancy over a 90-day period. Another MPT IVR under development is designed to release the ARV dapivirine and LNG for 2 months. Long-acting injectable pre-exposure prophylaxis (PrEP) formulations of rilpivirine (TMC278) and GSK1265744 have entered clinical evaluation and could form the basis of long-acting injectable products for HIV-1 prevention and prevention of unintended pregnancy. On-demand products include TFV 1% gel (HIV-1/HSV-2 prevention), a zinc/carrageenan zinc gel (HIV-1/HSV-2 prevention), and the SILCS diaphragm administered with TFV 1% gel. Significant technical, funding, and regulatory hurdles must be overcome to develop most MPTs; however, the significant reproductive health benefits to many women around the world should provide motivation to overcome these hurdles. This article is based on a presentation at the "Product Development Workshop 2013: HIV and Multipurpose Prevention Technologies", held in Arlington, Virginia on February 21-22, 2013. It forms part of a special supplement to Antiviral Research.
authors.affiliation: CONRAD Program, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, 1911 N. Fort Myer Drive, Suite 900, Arlington, VA 22209, United States. Electronic address: dfriend@conrad.org.
authors.forename: David R
authors.initials: DR
authors.lastname: Friend
authors.forename: Justin T
authors.initials: JT
authors.lastname: Clark
authors.forename: Patrick F
authors.initials: PF
authors.lastname: Kiser
authors.forename: Meredith R
authors.initials: MR
authors.lastname: Clark
mesh_terms: D000282:Administration, Intravaginal; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D003140:Communicable Disease Control / Q000295:instrumentation / Q000379:methods*; D003267:Contraception / Q000295:instrumentation / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control* / Q000635:transmission / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D011247:Pregnancy
chemical_list: D019380:Anti-HIV Agents
keywords: Contraception; HIV-1 prevention; Herpes simplex virus-2 prevention; Multipurpose prevention technologies