Scientists at RTI International are deeply involved on a variety of fronts in the fight against HIV, and a team of women is at the forefront of a new $4.8 million effort to help fight unwanted pregnancies as well as prevent HIV in sub-Saharan Africa.

Ginger Rothrock

“We are extremely passionate about this topic,” Ginger Rothrock, PhD, the project leader and director of technical development and commercialization at RTI.  The new contract, which was disclosed on World AIDS Day last week, is to develop a dual-purpose drug delivery device for both HIV and pregnancy prevention that can be successfully used in the sub-Saharan region.

“Our team is uniquely cross-disciplinary, encompassing physical science experts in drug delivery and product development and social science experts in assessment of the acceptability of and adherence to HIV and pregnancy prevention methods.

“We are excited to bring together this expertise to develop impactful MPT [multipurpose prevention technologies]  technology development.”

HIV infects 34 million people globally and the virus has caused 35 million deaths, according to World AIDS Day figures.

WRAL TechWire sought out the project leaders to talk about this new program and to provide an update on other efforts at RTI, which is based in Research Triangle Park and is involved in efforts around the world to better the human condition.

The U.S. Agency for International Development awarded the contract to RTI through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Other partners include UNC-Chapel Hill, U.S. Centers for Disease Control and Prevention and several others.

RTI cited three women on the project team, and while stressing their commitment to ” RTI’s mission, improving the human condition by turning knowledge into practice,” they also acknowledged their individual commitment to women.

Ariane van der Straten

“We personally choose to focus our research expertise on promoting the well-being of women globally,” said Rothrock, Ariane van der Straten who is senior fellow and director of RTI’s Women’s Global Health Imperative,  and Leah Johnson, a research chemist.

“By reducing unintended pregnancy and HIV transmission through access to modern technology, women can lead healthy lives. In addition to improved sexual and reproductive health outcomes, MPT use increases opportunities for educational and economic achievements.  As women in science, we actively seek the opportunity to make a positive impact on women globally, and are thrilled about this opportunity to pursue our greatest passion.”

Fighting unwanted pregnancy

In fact, pregnancy prevention is seen as being crucial to the success of the MPT.

Asked if pregnancy prevention in your view increase the interest of women in participating in the program and using such devices, van der Straten declared:

“Absolutely.  The population at the highest risk for HIV infection is young women, who are twice as likely to acquire HIV as young men the same age.

“These women are often not ready to start a family, and desire protection from HIV as well as contraception.

“This has been corroborated by our extensive interviews with end users and health care practitioners through other programs (labeled TRIO, QUATRO, IPrevent), where a combination (multipurpose, MPT) product was the most highly requested attribute by female end users.”

Health officials have said that voluntary family planning services access can prevent up to 1.5 million child deaths and over 100,000 maternal deaths a year.

The new project

“We’re excited to use innovation, science and technology to help foster control of the HIV/AIDS epidemic and stronger, more sustainable communities,” said Leah Johnson, who is the project’s co-leader.

Leah Johnson

The project is set to cover three years.

Rothrock says the implant could be precedent setting in capability and also meets a number of needs.

It also fits with the theme of World AIDS Day for 2017: “Increasing Impact through Transparency, Accountability, and Partnerships”

“The proposed innovative implant, which we call SCHIELD, aims to offer a combination of attributes that address end-user needs that are not met by existing technologies or those in advanced development,” she says.

The user attributes include:

  • User independence (designed to be inserted once a year)
  • Biodegredation (no difficult removal procedures)
  • Provide long-term protection (up to one year)
  • And discretion, based on the location of the implant

“It is worth noting,” she points out, “women have a diverse set of preferences and the current method mix is insufficient to meet those needs.

“Additionally, it has been shown that the use of contraception increases when more methods are available. Thus, adding additional technologies, including those like the RTI product that offer both contraception and HIV prevention, may serve to increase overall adoption.”

RTI’s HIV projects

RTI is waging battle against HIV on other fronts as well.

Van der Straten points out that “investigators at RTI  collaborate with other clinicians on clinical trials of new HIV prevention medications.”

She cited several:

“MTN-025/HOPE an open label extension of a phase III  effectiveness trial of the vaginal ring for HIV prevention in women and MTN-034, an open label phase II trial of oral PrEP and vaginal ring in adolescents and young women in sub-Saharan Africa.”

And: “We are also leading two critical clinical studies on user acceptability and preference that will inform product development.”

  • The TRIO Study: Acceptability of Different MPT Delivery Methods was a Gates Foundation funded program where RTI conducted a 5-month prospective clinical and mixed methods study to assess end-user preference and use of three product delivery forms (Tablets, Rings and Injections) for HIV and pregnancy prevention among 277 young women in South Africa and Kenya.
  • The QUATRO study (Acceptability study of (placebo) vaginal delivery forms for preventing HIV and unintended pregnancy) had a similar design and assessed preference and use of 4 vaginal products (ring, insert, film And gel)  among young women in Zimbabwe and South Africa, with funding from USAID and BMGF through CONRAD.

Another study, IPrevent, is designed “to understand preferences of end-users regarding long-acting HIV prevention products, in collaboration with the Desmond Tutu HIV Foundation in Cape Town, South Africa.”