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On-demand microbicide products: design matters

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Abstract

Sexual intercourse (vaginal and anal) is the predominant mode of human immunodeficiency virus (HIV) transmission. Topical microbicides used in an on-demand format (i.e., immediately before or after sex) can be part of an effective tool kit utilized to prevent sexual transmission of HIV. The effectiveness of prevention products is positively correlated with adherence, which is likely to depend on user acceptability of the product. The development of an efficacious and acceptable product is therefore paramount for the success of an on-demand product. Acceptability of on-demand products (e.g., gels, films, and tablets) and their attributes is influenced by a multitude of user-specific factors that span behavioral, lifestyle, socio-economic, and cultural aspects. In addition, physicochemical properties of the drug, anatomical and physiological aspects of anorectal and vaginal compartments, issues relating to large-scale production, and cost can impact product development. These factors together with user preferences determine the design space of an effective, acceptable, and feasible on-demand product. In this review, we summarize the interacting factors that together determine product choice and its target product profile.

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Acknowledgements

The authors are very thankful to Dr. Lindsay Ferguson Kramzer for critical reading and useful suggestions to improve the quality of this review.

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  1. School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, 15213, USA

    Sravan Kumar Patel & Lisa Cencia Rohan

  2. Magee-Womens Research Institute, Pittsburgh, PA, 15213, USA

    Sravan Kumar Patel & Lisa Cencia Rohan

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Patel, S.K., Rohan, L.C. On-demand microbicide products: design matters. Drug Deliv. and Transl. Res. 7, 775–795 (2017). https://doi.org/10.1007/s13346-017-0385-4

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