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Program impact and potential pitfalls of multi-purpose technologies (MPTs) for HIV prevention and contraception

The overlapping epidemics of HIV and unplanned pregnancy disproportionately affect adolescent girls and young women (AGYW) in sub-Saharan Africa. Prevailing dynamics driving benefits of any prevention method at the population level depend on: 1) population size, risk profile, and prevalence of metho...

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Autores principales: Latka, Mary H., Vahle, Kristin, Li, Kevin, Gomes, Megan, Dam, Anita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10505718/
https://www.ncbi.nlm.nih.gov/pubmed/37727532
http://dx.doi.org/10.3389/frph.2023.1249979
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author Latka, Mary H.
Vahle, Kristin
Li, Kevin
Gomes, Megan
Dam, Anita
author_facet Latka, Mary H.
Vahle, Kristin
Li, Kevin
Gomes, Megan
Dam, Anita
author_sort Latka, Mary H.
collection PubMed
description The overlapping epidemics of HIV and unplanned pregnancy disproportionately affect adolescent girls and young women (AGYW) in sub-Saharan Africa. Prevailing dynamics driving benefits of any prevention method at the population level depend on: 1) population size, risk profile, and prevalence of method use, 2) method efficacy, and 3) method use-effectiveness. Adding a multi-purpose technology (MPT) to prevent HIV and pregnancy to this three-part equation results in scenarios that may enhance HIV population impact, even with methods that exhibit less than “perfect” method efficacy, by extending protection among existing users and attracting new users, resulting in greater population coverage. However, the interplay of epidemic drivers is complex and the greatest population benefit of such a MPT would be realized among those most at risk for HIV and pregnancy, and could be harmful if successful contraceptive users switch to a method with lower use–effectiveness. While MPTs are highly desired, and may offer considerable individual, population, and system-level public health benefits, there is no “magic bullet”, nor single prevention method–MPT or otherwise–that will end the HIV epidemic nor fully resolve unmet need for family planning. All methods have inherent tradeoffs and women have varied reproductive and HIV prevention needs across their life course. Key programmatic features to maximize the potential of MPTs include offering them among a range of safe and effective methods with comprehensive information about their features allowing women to make a fully-informed method choice. Programmatic follow-up should support consistent and correct use to maximize use-effectiveness, and then monitor for potential untoward effects.
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spelling pubmed-105057182023-09-19 Program impact and potential pitfalls of multi-purpose technologies (MPTs) for HIV prevention and contraception Latka, Mary H. Vahle, Kristin Li, Kevin Gomes, Megan Dam, Anita Front Reprod Health Reproductive Health The overlapping epidemics of HIV and unplanned pregnancy disproportionately affect adolescent girls and young women (AGYW) in sub-Saharan Africa. Prevailing dynamics driving benefits of any prevention method at the population level depend on: 1) population size, risk profile, and prevalence of method use, 2) method efficacy, and 3) method use-effectiveness. Adding a multi-purpose technology (MPT) to prevent HIV and pregnancy to this three-part equation results in scenarios that may enhance HIV population impact, even with methods that exhibit less than “perfect” method efficacy, by extending protection among existing users and attracting new users, resulting in greater population coverage. However, the interplay of epidemic drivers is complex and the greatest population benefit of such a MPT would be realized among those most at risk for HIV and pregnancy, and could be harmful if successful contraceptive users switch to a method with lower use–effectiveness. While MPTs are highly desired, and may offer considerable individual, population, and system-level public health benefits, there is no “magic bullet”, nor single prevention method–MPT or otherwise–that will end the HIV epidemic nor fully resolve unmet need for family planning. All methods have inherent tradeoffs and women have varied reproductive and HIV prevention needs across their life course. Key programmatic features to maximize the potential of MPTs include offering them among a range of safe and effective methods with comprehensive information about their features allowing women to make a fully-informed method choice. Programmatic follow-up should support consistent and correct use to maximize use-effectiveness, and then monitor for potential untoward effects. Frontiers Media S.A. 2023-09-01 /pmc/articles/PMC10505718/ /pubmed/37727532 http://dx.doi.org/10.3389/frph.2023.1249979 Text en © 2023 Latka, Vahle, Li, Gomes and Dam. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Reproductive Health
Latka, Mary H.
Vahle, Kristin
Li, Kevin
Gomes, Megan
Dam, Anita
Program impact and potential pitfalls of multi-purpose technologies (MPTs) for HIV prevention and contraception
title Program impact and potential pitfalls of multi-purpose technologies (MPTs) for HIV prevention and contraception
title_full Program impact and potential pitfalls of multi-purpose technologies (MPTs) for HIV prevention and contraception
title_fullStr Program impact and potential pitfalls of multi-purpose technologies (MPTs) for HIV prevention and contraception
title_full_unstemmed Program impact and potential pitfalls of multi-purpose technologies (MPTs) for HIV prevention and contraception
title_short Program impact and potential pitfalls of multi-purpose technologies (MPTs) for HIV prevention and contraception
title_sort program impact and potential pitfalls of multi-purpose technologies (mpts) for hiv prevention and contraception
topic Reproductive Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10505718/
https://www.ncbi.nlm.nih.gov/pubmed/37727532
http://dx.doi.org/10.3389/frph.2023.1249979
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