Elizabeth Irungu

The Dual Prevention Pill (DPP) is likely to be the first MPT with PrEP to go to market. It is anticipated that the DPP could address women's concurrent needs for both pregnancy and HIV prevention and mitigate the challenges of stigma and partner dynamics that women face taking PrEP alone.

Jessica Rodrigues introduced the DPP as a co-formulated tablet containing oral pre-exposure prophylaxis (PrEP) and a combined oral contraceptive that women will be required to take on days 1-21 of the cycle and then take the oral PrEP pill on days 22-28. For effective DPP introduction it will be critical that both end-users and health providers in SRH spaces be educated on this intervention. Natasha Salifyanji Kaoma reported that pill burden and fear of side effects may be concerns that women may have about the DPP in addition to prefering a product they are familiar with. However, formative qualitative work conducted in Zimbabwe and South Africa as presented by Adlight Dandadzi and Siyanda Tenza indicated that health providers reported that DPP may have a positive impact on FP and PrEP, with DPP reducing the burden of taking 2 separate pills and thus improving the convenience of service delivery. Approaches to assessing cost effectiveness and modelling impact of DPP were presented by Danielle Resar. The follow up panel discussed need for policy shifts to allow considerations for introduction of DPP through the private sector including community pharmacies and observed opportunities brought by the DPP to bridge vertical HIV and FP programs.

Stigma has affected PrEP uptake and continued use among AGYW in sub-Saharan Africa. For women desirous of HIV and pregnancy prevention DPP has the potential to reduce stigma associated with PrEP-only products. Implementation research to inform scale up is planned in three African countries beginning 2021. However, successful introduction and roll out of the DPP and other future MPTs will depend on having a health system that is well resourced to provide quality services, a regulatory environment that enables product access and users who are well informed and supported by the community they come from.