July 15, 2016 |

What women want (in HIV protection)

PATH asked women to help us develop a new tool for HIV protection. The result: an innovative, first-of-its-kind drug delivery patch.
A girl and three women sitting by a wall.
When it comes to reproductive health products, women need to be part of the development process. At PATH, we start by asking them what they want. Photo: PATH/Patrick McKern.

What do women want?

Worldwide, women want—and deserve—safe products that enable them to control and protect their own health, whatever their physical, social, or cultural needs.

“That’s not just a nice thing to have, it’s a basic human right,” says Darin Zehrung, program advisor at PATH for vaccine and pharmaceutical delivery technologies, “and when it comes to creating effective health solutions, user-centered design and innovation go hand-in-hand.”

So when Darin’s team and their partners set out to develop a first-of-its-kind drug delivery patch to help women protect themselves from HIV, they went straight to the people who know women’s needs best: women themselves.

New tools, new choice

Man with his arm around woman.
Women want—and need—reproductive health options that not only work, but fit the realities of their lives. Photo: PATH/David Jacobs.

Worldwide, the burden of HIV falls most heavily on women. In sub-Saharan Africa, adolescent girls are more than twice as likely to be newly infected with HIV as boys of the same age, according to the United Nations Children’s Fund.

Reversing the trend requires empowering women with reproductive health options that not only work, but fit the realities of their lives. To help, PATH advances smart devices and tools that put health and protection in women’s hands.

The new patch, based on a breakthrough technology platform called the microarray patch (MAP), could be a powerful contribution. Small, safe, and painless, MAPs can effectively deliver drugs or vaccines through a person’s skin or mucosa. Some, for example, are designed to adhere to the skin like a small, unobtrusive Band-Aid.

PATH will be at the 21st International AIDS Conference, in Durban, South Africa, showcasing our work mobilizing local communities, public and private partners, governments, and leaders to tackle HIV head on.

PATH was already working to develop MAPs for safe, effective, and potentially self-administered vaccine delivery. Then, after talking with global health colleagues about how hard it can be for patients to access and use anti-HIV drugs, Darin and his team had another idea.

What if MAPs could be used to deliver the powerful antiretroviral drugs that help prevent HIV infection?

Getting PrEPared

Doctor writing on a form while talking to a woman.
Microarray patches (MAP) are a small, safe, and painless way to effectively deliver drugs or vaccines that could be available in the future by prescription or perhaps over the counter. Photo: PATH/Doune Porter.

Doctors know that giving healthy people anti-HIV drugs before they’re exposed during sex can help prevent them from getting the virus—an approach called pre-exposure prophylaxis, or PrEP. Today, people on PrEP take the drugs as a daily pill. The regimen is effective, but the pills can be inconvenient, easy to forget, and difficult to hide from curious partners or family members. That’s a particular concern for women in remote or low-resource communities, who often want products that are not only easy to obtain and use, but also long-lasting and private. A drug patch could provide a safe, discreet alternative.

Why listening and learning matters

Together with partners at Queens University Belfast in Northern Ireland, PATH advanced a range of concepts and ideas for the patch. But they still weren’t sure which option would prove most appealing for the women who need it most.

To find out, the PATH product development team travelled to South Africa to talk with a group of women, doctors, and health workers. Together, they discussed two long-acting, self-administered products for HIV PrEP: a small adhesive patch worn on the arm, and a dissolving vaginal patch (along with several possible applicators).

PATH’s product development team received key feedback from women, doctors, and health workers on two long-acting, potentially self-administered delivery options for HIV PrEP: a small adhesive patch worn on the arm, and a dissolving vaginal patch. Image: PATH.
PATH’s product development team received key feedback from women, doctors, and health workers on two long-acting, potentially self-administered delivery options for HIV PrEP: a small adhesive patch worn on the arm, and a dissolving vaginal patch. Image: PATH.

Overall, women and health providers alike were excited about the lifesaving potential of both patches.

Other responses surprised the team, says Darin, “—but that’s exactly why we ask.”

For example, the researchers thought the simple, easy-to-use arm patch would be the most popular option—but women had concerns. For example, would it fall off? More importantly, women worried that although easy-to-use, the arm patch would also be easy to see. They didn’t want to answer questions from their partners, family, or community.

By comparison, women viewed the vaginal patch as both easy-to-use and discreet. Already familiar with tampons and other vaginal products with applicators, they felt this option would not only work, but align much better with their everyday lives.

What’s next?

A closeup of a woman wearing a royal purple headwrap.
Our product developers take women’s feedback to heart. Photo: PATH/Mike Wang.

“Women’s insight is fundamental,” says Darin. “It’s key to the development of an appealing product that works for real women and meets their needs.”

Now, the PATH team is using what they’ve learned to narrow down and further develop early prototypes. They’re also asking new questions: What’s the best shape for the vaginal applicator? Can we design a patch that provides long-acting protection after being worn only a few minutes? Would a single patch combining PrEP with contraception be even more appealing?

To find out, PATH will keep testing, keep finessing, and keep listening to women: honing the product into a smart and effective tool that reflects what they need—and want.

USAID logo.Support for this project is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of the HealthTech Cooperative Agreement # AID-OAA-A-11-00051. The contents are the responsibility of PATH and do not necessarily reflect the views of USAID or the US Government.

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