As an HIV tester and counselor during my university days and beyond, I learned very quickly that most people have more pressing issues to deal with in their lives than HIV prevention. At at Oberlin College, I often saw clients shortly after an unprotected sexual encounter. For most, condom use to protect against HIV and other STIs had to be negotiated alongside myriad influential experiences and other barriers – including insecurity around the sexual relationship, fear around the sexual encounter, school stress, mental illness, and financial hardship, just to name a few. The very fact that these clients had proactively sought out an HIV test, demonstrated to me that they were both aware of and concerned about HIV risk, but that the prevention methods available to them just did not meet their needs or circumstances.

The Initiative for MPTs (IMPT) is dedicated to advancing the comprehensive sexual and reproductive health of women and girls worldwide. The Secretariat staff, who manage this global learning network, comprise a group of women who have worked a combined eight decades in the women’s health and sexual and reproductive health fields. From working with underserved women in Mauritania and the Ivory Coast as Peace Corps volunteers, to HIV testing and counseling in Baltimore, to community organizing in San Francisco and Sacramento, to conducting ethnographic research in Newfoundland, to coordinating HIV prevention clinical trials in Cape Town, our team’s diverse experiences and skills have contributed to the strategic advancement of the MPT field.

Every four minutes, three young women will become infected with HIV—that’s close to 900,000 new infections a year. While HIV prevention research and drug development have progressed rapidly, there is still work to be done. This World AIDS Day, we reflect on our work to advance MPTs by asking the IMPT Advisory Council for their perspective on the role of MPTs in the fight to end the HIV epidemic.

HIV prevention has come to the forefront of youth activism and public health advocacy, as young people aged 15-24 account for 35% of new HIV infections worldwide. In fact, as we work to curb the HIV epidemic, they are the only age group to experience a recent increase in HIV infections. Young people are disproportionately impacted by HIV and face unique challenges in protecting their sexual health as they navigate complex biological and social transitions into adulthood. In that spirit, the FDA recently approved PrEP (Pre-Exposure Prophylaxis) for adolescents, which has huge implications for empowering young people to prevent HIV exposure or transmission.

The field of MPTs that combine hormonal contraception (HC) and antiretroviral drugs for HIV prevention has made substantial progress in the past several years. There are two such MPTs in phase I clinical trials: 1) IPM’s dapivirine and levonorgestrel intravaginal ring and 2) CONRAD’s tenofovir and levonorgestrel intravaginal ring – with several other HC + ARV MPT products on the cusp in various stages of preclinical development.