HIV and Pregnancy Protection

Collaborative research from the University of Utah and reproductive health research organization CONRAD is working toward the goal of liberating contraceptive access with the first multipurpose pregnancy and disease prevention technology of its kind to be clinically tested.

The device, an intravaginal ring that simultaneously prevents pregnancy and reduces the risk of HIV and herpes simplex virus 2 (HSV-2) transmission, was presented this month at the the 2013 American Association of Pharmaceutical Scientists (AAPS) Annual Meeting and Exposition in San Antonio, Texas.

By combining two technologies into one device, the ring could make huge gains in protecting the health of women and their partners, especially in regions with high rates of unintended pregnancies and HIV transmission.

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How Does It Work? 

Intravaginal and intrauterine devices are not new, but the function of this particular product is unlike most currently on the market. The contraceptive levonorgestrel, when combined with the topical microbicide tenofovir, can prevent both unintended pregnancy and the transmission of HIV and HSV-2 for up to 90 days. The ring is designed to dispense a specific, controlled amount of levonorgestrel and tenofovir over time.

“By having a ring that can remain in the body for up to 90 days, our hope is that this ring will offer a solution to increase adherence, and therefore provide greater protection against HIV while also preventing pregnancy,” said Dr. David Friend, product development director at CONRAD, in a press release.

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Researchers performed tests in rabbits and sheep and compared the results to the effectiveness of tenofovir gel alone, which has been proven successful in preventing HIV infection in women. When using the ring, researchers found that levels of tenofovir in the target tissue were similar to or higher than those from gel application alone. The contraceptive levels were also on target with what is regarded as effective for women.

Why Do Women Need Another Form of Contraception? 

Many forms of contraception, including condoms, tend to be controlled by men in developing countries, says Dr. Meredith Clark, manager of drug delivery at CONRAD. But a device like the intravaginal ring could signal a change in how people view contraception. “This is a product that is used and controlled by the woman,” Clark says.

Multipurpose prevention technology is rare among mainstream birth control options. While condoms are very good at protecting against both pregnancy and HIV, the development of a device like the intravaginal ring demonstrates the potential for many more kinds of contraception, especially those that give women more control over their sex lives.

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The initial experiments show promise, but the success of the ring ultimately depends on whether people will feel comfortable using it.

“The introduction and acceptance of the ring needs to be explored,” Clark says. She predicts a learning curve but is optimistic about the ring’s possibilities and making a dent in the HIV/AIDS pandemic in regions like sub-Saharan Africa.

“We really hope this concept opens doors to getting [contraception] into women’s hands,” she says. 

Phase 1 clinical trials in humans will begin in 2014, when both the multipurpose ring and a tenofovir-only ring will be tested.