Drug-releasing vaginal rings for HIV/STI and pregnancy prevention: a review of recent advances and clinical applications

Expert Opin Drug Deliv. 2022 Jan;19(1):47-58. doi: 10.1080/17425247.2022.2020242. Epub 2022 Jan 7.

Abstract

Introduction: Adolescent girls and young women (AGYW), as well as pre- and post-menopausal women globally would benefit from expanded choice to address their sexual and reproductive health (SRH) needs related to Human Immunodeficiency Virus (HIV), sexually transmitted infections (STIs) and pregnancy prevention. Lack of adequate preventative vaccines for HIV/STIs reinforces public health prioritization for options women may use to mitigate risk for infectious disease and unplanned pregnancy. Drug releasing intravaginal rings (IVRs) represent one such technology that has garnered attention based on the modality's success as a pre-exposure prophylaxis (PrEP) delivery option in HIV risk reduction.

Areas covered: This article provides a synopsis of three IVR technologies in active clinical development for prevention of HIV, STI, and unintended pregnancy demonstrating advancements in terms of compatibility with a wide range of drug types with a focus on dapivirine-based silicone rings (International Partnership for Microbicides (IPM), tenofovir-based polyurethane rings (Conrad), and pod-based rings (Oak Crest Institute of Science)).

Expert opinion: The goals of IVR research are to reduce burdens of HIV/STIs and unplanned pregnancies. Through the evolution of IVR technologies, the potential exists to trigger integration of health-care services through formulation of products with multiple indications.

Keywords: HIV prevention; Intravaginal rings; STI prevention; contraceptives.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Contraceptive Devices, Female*
  • Female
  • HIV Infections* / drug therapy
  • HIV Infections* / prevention & control
  • Humans
  • Pharmaceutical Preparations
  • Pregnancy
  • Sexually Transmitted Diseases* / drug therapy
  • Sexually Transmitted Diseases* / prevention & control
  • Tenofovir / therapeutic use

Substances

  • Pharmaceutical Preparations
  • Tenofovir