Sexual & Reproductive Health
Multipurpose prevention technologies (MPTs) are a class of biomedical intervention that simultaneously provide protection – in varied combinations – against pregnancy, STIs or HIV in a single product.
MPTs can be preventative drugs (including microbicides) or devices in combination with a pharmaceutical element, offering protection for the following indications:
- Contraception + HIV prevention
- Contraception + STI prevention
- Contraception + STI + HIV prevention
- HIV + STI prevention
- Prevention from two or more non-HIV STIs (multiple STIs)
In LMICs, where the brunt of STIs, HIV and unintended pregnancies is felt, the prospective benefits of effective MPTs would be huge. The vast majority of all women with an unmet need for contraception are found in LMICs, while over two-thirds of all people living with HIV are found in sub-Saharan Africa alone. Over 90% of all STIs globally also occur outside of high-income countries.
MPTs that are appropriate for use in low-resource settings would allow sexually active people, particularly women and girls, the ability to protect themselves against multiple SRH issues with the convenience of one product, increasing efficiencies for users, as well as donors, procurers, and healthcare providers. Currently the only MPT available is the condom, and while highly effective, a diverse range of MPTs will be critical if the different needs of people in different circumstances and life stages are to be met, particularly women in LMICs.
Currently, the only available multipurpose prevention technologies (MPTs) are condoms, but progress in microbicide, biologic and drug R&D for contraceptives and STIs has spurred the development of products combining their prophylactic uses, especially via novel delivery methods. The MPT sector is user-centric and many products offer innovative user-controlled administration via topical gels, films or inserts. Some MPTs in development provide advantages specifically for people in LMICs: heat-stable vaginal rings and on-demand fast-dissolving inserts or topical gels may help solve storage and accessibility difficulties, since they can be distributed without requiring regular access to skilled health workers or cold chain. On-demand products provide unprecedented levels of agency, enabling consistent and discreet use. The potential of MPTs is generating momentum but most products are still in early development; out of 28 products in development, only six have reached clinical trials.
Population Council is conducting preclinical evaluations for an on-demand non-hormonal contraceptive and anti-STI fast-dissolving insert. It combines Q-Griffithsin, a nonantiretroviral lectin with potent anti-HIV activity, with anti-sperm and other excipients providing protection against pregnancy, HIV and bacterial vaginosis, chlamydia, gonorrhoea and HSV-2. Its use of a non-ART anti-HIV agent helps address risks of ART resistance.