Exploring user and stakeholder perspectives from South Africa and Uganda to refine microarray patch development for HIV PrEP delivery and as a multipurpose prevention technology

• Published in: PloS one Vol. 18; no. 8; p. e0290568
• Main Authors: Ismail, Ayesha, Magni, Sarah, Katahoire, Anne, Ayebare, Florence, Siu, Godfrey, Semitala, Fred, Kyambadde, Peter, Friedland, Barbara, Jarrahian, Courtney, Kilbourne-Brook, Maggie
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 31.08.2023; Public Library of Science (PLoS)
• Subjects: Acceptability; Acquired immune deficiency syndrome; Adolescents; AIDS; Analysis; Antiretroviral agents; Biology and Life Sciences; Birth control; Condoms; Contraceptives; Disease prevention; Drug delivery; Drug delivery systems; Drug self-administration; Drugs; End users; Engineering and Technology; Girls; Health risks; HIV; HIV (Viruses); Human immunodeficiency virus; Infections; Medicine and health sciences; Men; Needles; People and Places; Preferences; Pregnancy; Prevention; Product development; Prophylaxis; Prototypes; Qualitative analysis; Reproductive health; Sex industry; Sexual health; Sexually transmitted diseases; STD; Technology; Teenage girls; Teenage pregnancy; Thigh; Transdermal medication; Usability; User needs; Vagina; Women; Womens health; Young adults; Youth; South Africa; Uganda; Sub-Saharan Africa; Africa
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0290568

Oral HIV pre-exposure prophylaxis (PrEP) is highly effective, but alternative delivery options are needed to reach more users. Microarray patches (MAPs), a novel drug-delivery system containing micron-scale projections or "microneedles" that deliver drugs via skin, are being developed to deliver long-acting HIV PrEP and as a multipurpose prevention technology to protect from HIV and unintended pregnancy. We explored whether MAP technology could meet user and health system needs in two African countries. All groups expressed interest in MAP technology, reporting perceived advantages over other methods. Most participants preferred the smallest MAP size for ease of use and discreetness. Some would accept a larger MAP if it provided longer protection. Most preferred a protection duration of 1 to 3 months or longer; others preferred 1-week protection. Upper arm and thigh were the most preferred application sites. Up to 30 minutes of wear time was considered acceptable; some wanted longer to ensure the drug was fully delivered. Self-administration was valued by all groups; most preferred initial training by a provider. Potential users and stakeholders showed strong interest in/acceptance of MAP technology, and their feedback identified key improvements for MAP design. If a MAP containing a high-potency antiretroviral or a MAP containing both an antiretroviral and hormonal contraceptive is developed, these products could improve acceptability/uptake of protection options in sub-Saharan Africa.