The global health community is calling for increased investment in the development of new technologies for women to protect against unintended pregnancy, HIV and other sexually transmitted infections. A new supplement published today in BJOG: An International Journal of Obstetrics and Gynaecology (BJOG), from the World Health Organization (WHO) and CAMI Health, focuses on Multipurpose Prevention Technologies (MPTs), which aim to improve the sexual and reproductive health of women worldwide.
Currently male and female condoms are the only method which provides combination prevention against unintended pregnancy and STIs, including HIV, but more options are needed.
Investments in improving women’s sexual and reproductive health (SRH) over the years have resulted in fewer unintended pregnancies; fewer maternal and newborn deaths; and healthier mothers and children. However, levels of unintended pregnancy, HIV and other sexually transmitted infections (STIs) remain high.
Within this new supplement, one review looks at the public health rationale for MPTs and explores the sexual and reproductive health risks facing women worldwide.
It looks at unintended pregnancies and estimates that annually 80 million unintended pregnancies occur in the developing world as a result of contraceptive failure and not using any form of contraception. These unintended pregnancies result in unplanned births, abortions and miscarriages.
Furthermore, the review discusses the risks posed to adolescents with approximately 14 million adolescents in the developing world giving birth each year. Women under the age of 16 who give birth are more likely to experience premature labour, miscarriage and stillbirth, as well as death from pregnancy-related causes.
HIV also heavily impacts maternal, infant and child health and survival. It is the leading cause of mortality of women of reproductive age, with HIV-related maternal mortality rates in sub-Saharan Africa increasing, states the review. Each year, approximately 1.4 million women living with HIV become pregnant. In sub-Saharan Africa, the proportion of women living with HIV among antenatal clients ranges from 5% to 30%. HIV infection in childbearing women is the main cause of HIV infection among children, as more than 90% of infant and young child infections occur through mother-to-child transmission.
The paper also looks at other STIs and states that an estimated 500 million people globally acquire one of four curable STIs each year: syphilis, gonorrhoea, chlamydial infection and trichomoniasis.
Heather Boonstra, Director of Public Policy at the Guttmacher Institute, Washington, DC, USA, and lead author of the review paper said:
“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.”
Dr Marleen Temmerman, Director of the Department of Reproductive Health and Research at WHO said:
“New MPTs will drastically improve the sexual and reproductive health of women globally if used correctly.
“A particularly vulnerable group are adolescent girls. They may seek to terminate their pregnancy following an unplanned pregnancy and may have an unsafe abortion posing a huge threat to their health. The development of new technologies and better education and understanding of the options available will transform lives.”
Within the supplement another paper discusses the next MPT in the pipeline, a microbicide product which has the potential to prevent both HIV and HSV-2 acquisition (herpes). Moreover, a further paper highlights other products, beyond microbicides and looks at combination drug products which could achieve the result of preventing multiple sexual and reproductive health risks to women and young girls.
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The full supplement can be found here: http://onlinelibrary.wiley.com/doi/10.1111/bjo.2014.121.issue-s5/issuetoc
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Please include a link to the full supplement in online coverage: http://onlinelibrary.wiley.com/doi/10.1111/bjo.2014.121.issue-s5/issuetoc
Boonstra H, Barot S, Lusti-Narasimhan M. Making the case for multipurpose prevention technologies: the socio-epidemiological rationale. BJOG 2014; DOI: 10.1111/1471-0528.12851