AVAC on World AIDS Day: We’re 20. We’re not giving up.

When AVAC was founded in 1995, we were called the AIDS Vaccine Advocacy Coalition. Our singular goal was to advance swift, ethical research for a vaccine that was then — and is today — essential to bring the epidemic to a conclusive end.

Twenty years later, AVAC is still focused on swift and ethical research, but our scope has expanded. Along with vaccines, we advocate for PrEP, microbicides, voluntary medical male circumcision and more.

Through it all, our message has been the same: prevention is the center of the AIDS response. Not just any prevention but smart, evidence-based, community-owned, rights-based strategies.

We do this work because it’s essential. We are able to do it because of our robust partnerships worldwide. We will keep doing it — with your help — until the epidemic has, finally, come to an end.

We’ve experienced 20 years of breakthroughs and disappointments in prevention research. A vaccine that many had given up on was the first to provide modest protection. One microbicide everyone hoped for didn’t pan out. Male circumcision and PrEP studies overcame skepticism and, together with antiretroviral therapy, paved the way for a prevention revolution.

Through it all, AVAC has worked with partners to maintain the field’s focus and press for continued research into an AIDS vaccine, a cure and more.

When AVAC was founded, the only biomedical HIV prevention options for adults were male and female condoms. The pathway for introducing any new strategy was largely unmapped. No one knew where the gaps would be—between trial result and country action, between guidance and financial support. Now we do.

Over two decades, AVAC has not only identified the gaps; we’ve worked to bridge them, so that products reach people in programs that work — without delay.

Twenty years ago, advocacy for HIV prevention hardly existed. So AVAC helped build a global network of advocates equipped with effective advocacy strategies and the latest evidence.

With our support, they are putting prevention on the agenda in countries and communities around the globe.

When the world lacked a plan for ending AIDS, we helped create one.

Now we’re holding global leaders accountable for results — demanding the resources, policies and evidence-based plans needed to deliver all of today’s prevention options to the people who need them, and to plan for the rapid rollout of new options as they emerge.

Communities’ support for prevention research can never be taken for granted — it has to be earned. For 20 years, we’ve helped build trust between researchers, funders and communities to speed the ethical development and rollout of new prevention options.

And when controversy threatened to derail those efforts, AVAC provided leadership and resources to help get them back on track.

Your gift to AVAC will support our efforts to accelerate the development and delivery of HIV prevention options to men and women worldwide. With your help, we can continue to convene, collaborate and communicate a strong, clear and cohesive vision for HIV prevention today, tomorrow and to end the epidemic.

It will take all of us working together to end AIDS. Please join us.

Intervention Update: Hormonal Contraception and HIV

Excerpted from AVAC Report: HIV Prevention on the Line, this update describes recent discussion and analysis in the search for answers as to whether hormonal contraceptives, including long-acting methods such as Depo-Provera (DPMA) and other injectable contraceptives and the implant, affect women’s risk of acquiring HIV.

AVAC Report: HIV Prevention on the Line

AVAC’s annual report of the field, the upcoming CROI meeting and why the coming year is the best and worst of times for HIV prevention

Next week, scientists, advocates and clinicians will gather in Seattle for the Conference on Retroviruses and Opportunistic Infections (CROI), a venerable HIV meeting that often triggers media coverage of the AIDS epidemic and the potential for curbing it and preserving health in people living with HIV.

A range of data is expected from CROI including “late-breaker” abstracts that will showcase data from IPERGAY and PROUD, two trials of oral PrEP using TDF/FTC in gay men and other men who have sex with men in Europe and Canada, and another trial of the microbicide 1% vaginal tenofovir gel in South African women. There will also be data from a PrEP “demonstration project” that provided the strategy in a real-life context for Kenyan and Ugandan couples with one HIV-positive and one HIV-negative partner.
We don’t know what the specific headlines will be, but we can say with confidence that one take-away must be this: The future of HIV prevention is on the line.

In our latest report, AVAC Report 2014/15: Prevention on the Line, we provide a clear agenda for what needs to happen, what’s missing, and why it matters now more than ever before.

Specifically, we argue that:

  • Ambitious prevention goals matter. They can galvanize new action, in part by expanding our sense of what’s possible.
  • But these goals will only work if they’re feasible, well-defined, measurable, and backed by adequate resources and political support. The prevention goals issued so far are inspiring but they don’t yet meet those requirements.
  • As the UNAIDS “Fast Track” for 2020 set aspirational goals, clear short-term targets are also urgently needed. We can’t wait for five years to see if the world is on track to end the AIDS epidemic.
  • The global AIDS response is running at a major financial deficit. New targets will not be met—and may even be irrelevant—if we fail to close a growing global funding gap.

Recent breakthroughs in HIV research have transformed the ability to curb new infections, making it possible to contemplate the end of the global AIDS epidemic. But prevention could be left behind if global leadership fails to make it a priority.

Recently, UNAIDS issued broad goals for HIV testing, ART provision and virologic suppression over the next five years. According to the agency, achieving these “90-90-90” goals would put the world on track to effectively end the AIDS epidemic by 2030.

On the prevention front, UNAIDS seeks to reduce new infections worldwide from 2.1 million in 2013 to 500,000 in 2020, and to eliminate stigma and discrimination. These are ambitious goals and worth aspiring to. But something important is missing from the picture—intervention-specific targets with the specificity, strategy and resources to match. The goal is great. What’s missing is how to get there.

In twenty years, we will have ample hindsight as to whether today’s targets mattered in the quest to end AIDS.

But right now, foresight and focus are urgently required. We’re concerned about whether the targets that have been set are the right ones, how much targets matter—particularly in the context of a global response running at a disastrous funding deficit—and where prevention targets other than those focused on the antiretrovirals in HIV-positive individuals—fit in. We’re also cognizant that targets can turn from audacious to absurd in the blink of an eye if financing, political will and community buy-in are missing.

AVAC works in coalitions in many of the countries hardest hit by the epidemic. Targets that are developed Geneva, Washington DC and other corridors of power can bear little resemblance to the realities of AIDS endemic countries and communities. Where there’s no reality, there’s no relevance. It’s essential that countries have the technical and financial resources to make global targets relevant to national context. Otherwise, the loftiest goals will be ignored.

As we argue in this Report, targets have played a critical role in changing the course of the epidemic. Likewise, a poorly-thought out target can have no impact at all. Right now, it’s critical that targets and tactics are matched to the lofty but achievable goal of bringing an end to AIDS. This is why we’ve devoted the first section of the Report to a look at why targets matter, what targets are missing, and how advocates for a comprehensive response need to work together to ensure smart, strategic targets across the spectrum of prevention options.

We also focus on issues that underpin (and, sometimes, undermine) the ability to meet these targets. We identify three specific areas for action:

  • Align high impact strategies with human rights and realities. Biomedical advances of the past eight years have made it scientifically plausible to talk about ending the epidemic. But plausible doesn’t mean possible. Today some scientists and public health professionals are focused on what can be achieved biomedically—without enough attention to the structural and social contexts in which treatment prevention are delivered. At the same time, some rights-focused partners speak of HIV as being exclusively pill-oriented, suggesting that there isn’t any dynamism or action on the rights-based fronts. It need not be a permanent rift—indeed it cannot be. If science does not get synched up with human rights then then there is little hope of bringing the epidemic to a conclusive end.
  • Invest in an oral PrEP-driven paradigm shift. The world is failing to deliver the most effective interventions with smart strategy and at scale. Daily oral PrEP for HIV prevention is just one example. Global targets for PrEP may be released in the coming months, but there aren’t any plans in place to meet them. Demonstration projects are small and disconnected, funding is limited and policy makers aren’t heeding the growing demand from men and women, including young women in Africa. Now is the time to spend and act to fill these gaps.
  • Demand short-term results on the path to long-term goals. It will be years before the world has an AIDS vaccine, cure strategies, long-acting injectable ARVs or multipurpose prevention technologies that reduce the risk of HIV acquisition and provide contraception. But there’s plenty of activity in clinical trials and basic science for these long-term goals. This activity needs to be aligned with short-term goals that can be used to measure progress and manage expectations.

As AVAC Report goes to press this week and as we prepare for CROI next week, the United States is grappling with profound questions about the ways that the lives of Black men and women are valued under the law. The world is trying to understand how the West African Ebola epidemics got out of control—and how to bring them to an end. And there is continued concern and vigilance over anti-homosexuality laws in Nigeria and the Gambia, and in hate-mongering environments and legislation that endanger LGBT individuals and many other marginalized groups around the world.

These events are not separate from the work that we do to fight AIDS. They embody the issues of racism, inequity, poverty and security that drive the epidemic that must be addressed to end it. In addition to the HIV-specific work laid out in these pages, it is essential to work towards fundamental, lasting and positive change in each of these areas. That will be history-making, indeed.

Press Release

With future of HIV prevention “on the line,” AVAC calls for sharper, bolder strategy to end the epidemic

Contacts

Mitchell Warren, mitchell@avac.org, +1-914-661-1536

Kay Marshall, kay@avac.org, +1-347-249-6375

New York — In a report issued today, AVAC warned that global HIV prevention efforts are in jeopardy due to an absence of strategic targets, resources and specific implementation plans to translate science, slogans and goals into action. The report calls for a robust set of global HIV prevention targets tailored to specific interventions and demands action in several key areas of the global AIDS response, including expanded rollout of daily oral pre-exposure prophylaxis, or PrEP, and alignment of science and human rights-based agendas.

“We’re at a make-or-break moment and the future of HIV prevention is on the line,” said Mitchell Warren, AVAC’s executive director. “Advances in HIV treatment and prevention research have made it possible to contemplate ending the AIDS epidemic in our lifetimes, but that will only happen with smarter planning, increased resources and greater accountability.”

The report was released ahead of the Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle (Feb. 23-26), where researchers are expected to present data from several major HIV prevention trials, including studies that could help drive global implementation of PrEP, as well as a key study of a tenofovir-based vaginal gel for women.

Report calls for smart, realistic goals and targets for HIV prevention

Today’s report, entitled Prevention on the Line, takes a close look at global goals for HIV prevention and what it will take to make them a reality. UNAIDS recently adopted the broad goals of reducing new HIV infections worldwide from 2.1 million in 2013 to 500,000 and eliminating stigma and discrimination, both by the year 2020.

Drawing upon lessons from WHO’s “3 x 5” HIV treatment initiative and other case studies, the AVAC Report concludes that ambitious prevention goals are critical – but that they will only work if they’re feasible, well-defined, measurable and supported with adequate resources and political commitment. In the case of the new UNAIDS prevention goals, the report points to a critical need for more specific, interim targets that can be tracked between now and 2020; for better data and monitoring approaches; and for resource allocations that are directly tied to achieving those targets.

“The UNAIDS prevention goals for 2020 are ambitious and inspiring,” said Warren. “But something important is missing from this picture: how to get there. We need a clear path forward, including short-term targets, so we don’t wait five years to see if the world is on track. And new targets won’t be met – and may even be irrelevant – if we fail to close the growing global funding gap for HIV prevention.”

Bold action needed to advance AVAC’s agenda to end AIDS

The report also recommends key actions to advance AVAC’s three-part agenda to end AIDS. First issued in 2011, the agenda calls for sustained efforts to deliver proven prevention tools, demonstrate and roll out new options such as PrEP and develop long-term solutions such as long-acting ARV-based prevention, vaccines and cure strategies.

Key recommendations for 2015 include:

1. Align high-impact HIV prevention with human rights and realities. Research has demonstrated the potential of high-impact prevention strategies, including biomedical approaches like HIV treatment for people living with HIV and voluntary medical male circumcision (VMMC). But these strategies won’t succeed in the real world if we give short shrift to human rights concerns, or if we fail to involve affected communities in designing and implementing prevention programs. Recent experience with treatment and VMMC, in particular, has shown that community buy-in is an essential ingredient of successful rollout and scale-up.

2. Invest now to scale up access to PrEP. Landmark trials have shown that daily oral PrEP is a powerful HIV prevention tool, and studies at next week’s CROI meeting could provide additional support. But the pace of rollout remains far too slow. Demonstration projects are small and disconnected, funding is limited and policy makers are not yet heeding growing demands for access. Funders should invest now in large-scale targeted implementation of PrEP, linked to national programs. National regulatory authorities and health ministries should prioritize licensure and rollout.

3. Accelerate research into long-term solutions. We must sustain and accelerate research on solutions such as an effective AIDS vaccine, long-acting antiretroviral prevention and treatment and a cure. Just like the rest of the AIDS response, this research needs its own short-term targets, aligned to long-term goals.

The new report and related resources, including downloadable graphics, are available now at www.avac.org/report2014-15.

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About AVAC: Founded in 1995, AVAC is a non-profit organization that uses education, policy analysis, advocacy and a network of global collaborations to accelerate the ethical development and global delivery of AIDS vaccines, male circumcision, microbicides, PrEP and other emerging HIV prevention options as part of a comprehensive response to the pandemic.

UNAIDS Report has Bold Vision, Key Messages—But Needs More Precision on HIV Prevention

UNAIDS recently released Fast Track: Ending the AIDS Epidemic by 2030, its report for World AIDS Day (December 1, 2014). Coming nearly two weeks early, the launch was, itself, fast-tracked—and there’s plenty of “we can’t wait” urgency within the pages of the report, starting with the first page (that does more, typographically, with red ribbons than you might believe is possible). It reads:

“We have bent the trajectory of the AIDS epidemic. Now we have five years to break the epidemic or we risk the epidemic springing back even stronger.”

This is on target and a message to convey urgently and with clarity. UNAIDS has its work cut out as an agency that can provide leadership, mobilize resources and push for the shift to community-based service delivery that emerges as one of the core recommendations in the report.

In broad strokes, it’s the right message, with the right vision, at the right time.

But an effective response depends on strategy, details, milestones, resources and specifics—and these are still lacking. This is to be expected, as the UNAIDS Prevention and Non-Discrimination Targets are still in draft form.

The Fast Track World AIDS Day report is clear on what needs to happen to achieve the “90-90-90” goal that calls for 90 percent of people living with HIV to know their status, 90 percent of those to be on antiretroviral therapy (ART) and 90 percent of those to be virologically suppressed by 2020.

It also suggests the components of prevention programming that should also come on line—listing, in various places, male and female condoms, voluntary medical male circumcision, oral pre-exposure prophylaxis (PrEP) for sex workers, men who have sex with men, serodiscordant couples and adolescents, as well as cash transfers for young girls, harm reduction, structural interventions, mass media and behavior change. These prevention elements appear in different subsets throughout the document, leaving some confusion about what, exactly, is essential.

Everything that the UNAIDS report lists is important. But the details of what goes where—which packages, in which places—and what specific terms mean are missing. Cash transfers, for example, can be delivered in a range of ways, with different objectives and different outcomes.

There are also some elements that receive considerably less emphasis. Research and development of more potent ARVs for treatment and prevention, new prevention options for women and other key populations, vaccine and cure strategies, are fundamental to long-term success in “breaking the epidemic”. Within the five-year timeframe set by UNAIDS, there are short-term milestones to set and achieve in each of these areas, even though the ultimate goals may not be reached for many years.

The good news is that this is a solvable problem. We as advocates and activists must use our impatience and collective wisdom to fast-track a process to ensure that clear targets, resources and messages are developed with the same strategy, rigor and urgency as 90-90-90.

AVAC is working with many of our partners to inform this process. This new report adds urgency to this task and clarity to the questions we need to address. As the report stresses, we must all “hold one another accountable for results and make sure no one is left behind.”

In the coming days, AVAC will release “Prevention on the Line”—a briefing paper with core recommendations for effective target-setting across the research-to-rollout continuum. This will summarize core messages and analysis that will be expanded in AVAC Report 2014/15. To receive the Report and other updates in your inbox, please join our Advocates’ Network. Stay tuned—and stay in touch.

Click here to download the new UNAIDS report.

Updates on Multipurpose Prevention Technologies: New Trial, Webinar and Advocacy Voices

CONRAD launches first-ever multipurpose vaginal ring clinical trial; a technology that combines contraception, HIV and herpes prevention. Last week, AVAC and CAMI Health co-hosted a webinar: MPT Acceptability in Uganda, Nigeria, and South Africa with researchers from Ipsos who discussed methods and key findings from their market research study. And check out AVAC Fellow Everlyne Ombati’s recent blog post reflecting on conversations on MPTs she had at HIV R4P.

Click here for:

What do women want in multipurpose technologies?

Multipurpose Prevention Technologies (MPTs) are a fast-growing area in women’s sexual and reproductive health. On November 12, AVAC and CAMI Health co-hosted a webinar: MPT Acceptability in Uganda, Nigeria and South Africa.

MPTs as Seen From a Bowl of Salad Combo

Salad! Fruit salad! Vegetable salad! You know, the type that come with all the goodness served in one bowl. Or those that you get to choose the combinations that sate your palate’s desire? Sometimes I’m perfectly okay with slicing a succulent cucumber and sprinkling it with some creamy garlic vinaigrette. When I want to outdo myself, I love taking my time to make a good chopped salad, and I will add a variety of nuts and seeds to make it richer. The result is a yummy bowl named Chef Eve’s Saturday Special. My neighbor calls it “The rabbit diet”. Some of my friends would rather have the nuts and leave the “leaves” alone; others think I need prayers for some of my food choices. My mother tells me I need to eat “real” food more often. Well, we all have diverse tastes, and different food preferences. This salad combo works perfectly for me. No burned fingers, and most importantly no scrubbing burnt cooking pots afterwards.

And salad, my dear friends is what exactly I think about when someone mentions Multipurpose Prevention Technologies (MPTs). These are products in development that would simultaneously address multiple sexual and reproductive health needs, including prevention of unintended pregnancy; prevention of sexually transmitted infections (STIs), including HIV, and/or prevention of other reproductive tract infections (RTIs), such as bacterial vaginosis or urinary tract infections. 

Several MPT formulations were presented at the recent HIV Research for Prevention or “R4P” conference in Cape Town (October 27-31, 2014). The ones discussed in Cape Town combine contraceptive and microbicide approaches to prevent pregnancy, HIV—and, in some cases, other STIs like herpes—into one product. How can this not be exciting to anyone? While these products do not exist yet, the idea is a great one: You pop a pill, and voila! You hit the freeway. 

Not really, but it could be liberating to have a prevention tool that allowed you not worry about pregnancy or HIV. 

Daily oral PrEP using tenofovir is already an option women could use—and lots of women talked about it in Cape Town—as a way to take control over HIV prevention and stop worrying about our husband or boyfriend having a “mpango wa kando” (Swahili slang name for multiple sexual partners). 

In the future, an MPT injection might be developed that would let you get a tiny unpainful jab (at least that’s what I hope it will be; no one likes needles!), and for one, or two or three months or more, you need not think about pregnancy, or HIV, or herpes. And then there are those of us who would want to have a baby but then would not want to have an infection. Well, guess what? MPTs could  have our backs covered too.  There is research into MPTs that will prevent HIV and STIs but allow for pregnancy. Just like salad, if you don’t like nuts, we can make you a garden “combo” or we can just slice up the cucumber; there are many options! The choice is yours. Dr. Nelly Mugo, a researcher at KEMRI likes to say “The same thing does not work for the same woman all the time.” I agree, whole heartedly. Some days, I don’t even want to see my best combo salad. Some days I just want a giant mug of the over-priced pumpkin spice latte! If only we had Starbucks in Kenya!

Let’s just pause for a minute, and do the math. No, not advanced calculus, just big numbers and percentages. Statistics show that globally, approximately 35.3 million people are living with HIV. Sub-Saharan Africa remains most severely affected, accounting for 71% of the people living with HIV worldwide. More than half of them are women. Approximately 40% (80 million annually) of all pregnancies are unintended. 80 million! That’s about twice the population of my lovely country Kenya! This is a mind-boggling number. More than three-quarters of these pregnancies occur among women with an unmet need for contraception living in low-resource countries. It is estimated that approximately half of all unintended pregnancies end in illegal abortions likely occurring under unsafe conditions, leading to maternal deaths, and either temporary or permanent disabilities among millions of women. The WHO maps provide an over view of the global SRH burden. In the MPT session this morning, the maps were dubbed as “the warm colored maps” showing large regions of unmet SRH needs, and seems that the brighter the colors the higher the prevalence of HIV/STI or unmet family planning needs or the more deaths they indicate. How sad. Some of those colors are really fancy. I hope they do maintain those lovely colors when MPTs will be out in the market doing what they were developed to do, and then the colors can show the decline in HIV, decline in maternal health, decline in unintended pregnancy. Decline. Decline. Decline.  Am a dreamer. And all dreams are valid. Ask Lupita Nyong’o.

Now, imagine the possibility product that would reserve this numbers! I am looking forward to that day. It is so exciting to know that developers, scientists, social behavioral scientist and market researchers are all burning midnight oil in a collaborative effort to ensure successful development and delivery of MPTs. To suit our diverse SRH needs, MPTs are being developed in diverse formulations. For instance a single sized diaphragm is being evaluated in South Africa as a reusable delivery of a microbicide gel that could reduce the risk of HIV. The diaphragm is already a contraceptive that prevents unwanted pregnancy. It also presents an option for non-hormonal barrier contraception. With an anti-HIV gel, it could be a one-two punch. 

There several other MPTs under development including intravaginal rings that combine contraceptive hormone with ARVs for HIV and HSV2 prevention; and multipurpose injectables. These different formulations provide many options for women and could also allow women to use a product without necessarily negotiating with their sex partners. The need to have HIV prevention options that do not require negotiation with a partner,was emphasized in one of the lunch time session at the Advocate’s Corner. At HIV R4P. One of the participants expressed concerns that all options currently available need some form of negotiation, and if one is not negotiating one is wondering if their partner is “wearing their ARVs”. Such are the issues that make me think MPTs could not have come at a better time. 

Even though MPT are still at the very early stages of development, a lot of progress has been made so far. But even as stakeholders continue with the development process, there are a number of unanswered questions that need to be addressed; do we know if MPTs will be effective? Do we know what women want? Do women know what they want? When these products will be found to work how will they be provided to those who need it? Will the MPTs be easily assessable when available? Will the women afford the products? How do we address issues around provider attitude? Will we be able to manufacture them? These are just a few of the many questions that need answers.  As Prof Elizabeth Bukusi said in Cape Town, the process is like navigating your way on a very muddy road, one is never really sure if they will get to the end, but there is always hope that you will get there, “and if you can’t take the road, take the boat” she said. We need to think about where we have come from so far, where we are at with the epidemics, and find a way to get us to where we are going.

For more information on MPTs, make sure to check out:

Webinar: What do women want in multipurpose technologies?

Multipurpose Prevention Technologies (MPTs) are a fast-growing area in women’s sexual and reproductive health. On November 12, AVAC and CAMI Health co-hosted a webinar: MPT Acceptability in Uganda, Nigeria and South Africa.

Webinar Materials

The webinar summarized methods and key findings from the market research study conducted by Ipsos Healthcare, with support from the Bill & Melinda Gates Foundation, to assess the acceptability of multipurpose options among women in Uganda, Nigeria and South Africa.

The webinar discussed:

  • What women in Uganda, Nigeria and South Africa shared about sexual behavior, contraceptives and HIV prevention needs—and how this information will be used to shape the MPT agenda.
    What the research found about the acceptability of four potential MPTs (injectables, implants, intra-vaginal film, intra-vaginal ring).
  • Jeff Lucas and Moushira El-Sahn from Ipsos Healthcare summarized methods and key findings from the market research data, and Bethany Young-Holt from CAMI Health moderated the discussion.

This call was one of the latest updates in the MPT field. Here are some other resources of note:

Special Issue of BJOG on Multipurpose Technologies

This week a new issue of the journal BJOG: An international Journal of Obstetrics and Gynaecology published a suite of articles (all open access) on the future of “multipurpose” options that would provide both contraception and protection against HIV and/or other sexually transmitted infections. It is a strong series of updates related to the science and policy of new product development and an excellent overview of the state of play of this critical area of work.

For decades, advocates working on both HIV prevention and sexual and reproductive health have spoken about the need for strategies that multiple issues, multiple needs. This is true for all people—our bodies require many types of care and treatment, and the more places we have to go to get what we need, the more likely it is that something… doesn’t get taken care of. It is particularly true for women, who have urgent needs for HIV prevention and contraception that is safe, effective and discrete. HIV positive women have similar needs—that extend to HIV treatment that works with their contraception.

The contributions include one from Helen Rees, leader of the Wits Reproductive Health and HIV Institute and long-time women’s health advocate Anna Forbes on “Policy implications for multipurpose prevention technologies service delivery“. AVAC Executive Director contributed a piece, “Condoms: the multipurpose prevention technologies that already exist“. The full volume is also available.

A blog post on the issues quotes Heather Boonstra, Director of Public Policy at the Guttmacher Institute, Washington, DC, USA, and lead author of the review paper:

“The evidence strongly indicates that providing women with effective new tools to simultaneously prevent unwanted pregnancy as well as STIs and HIV is essential. 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.

“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. 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.”