Multipurpose vaginal rings for HIV prevention and treatment of bacterial vaginosis

This thesis is focused on the developvent of a multipurpose prevention technology (MPT) vaginal ring that can provide sustained release of two or more of the following actives: dapivirine (DPV, a potent experimental antiretroviral); metronidazole (MET, 5-nitroimidazole antibiotic drug); sucrose (selectively promotes the growth of lactobacilli), and boric acid (antimicrobial and antibiofilm properties) to prevent HIV infection and, at the same time, treat or prevent BV.

A matrixtype silicone elastomer vaginal ring developed by the International Partnership for Microbicides (IPM) and providing 28-day continuous release of DPV, a non-nucleoside reverse transcriptase inhibitor (NNRTI), was prequalified by the WHO in 2020 and received a recommendation in WHO’s HIV guideline in 2021. The development of next-generation vaginal rings is primarily focused on so-called ‘multipurpose prevention technology’(MPT) products which aim to simultaneously prevent HIV-1 infection, unintended pregnancy and other sexually transmitted infections using a single product.