A Review on HIV Transmission in the Female Reproductive Tract and Preformulation Considerations for Intravaginal Drug Delivery of Prevention Technologies

Abstract

The female reproductive tract consists of several anatomical and physiological features that present high risk for HIV and sexually transmitted infections in women. Clinical and epidemiological research has shown significant variation in risk of transmission and co-infections for different age groups and pregnancy status. Around 63% of all newly acquired HIV infections are in women aged 15-24 years and access to prevention product options that are safe, user friendly and comfortable remains low. Design and development of intravaginal drug delivery products provides better option for discreet and user-friendly methods for HIV prevention in women. Products that have good bioadhesive properties, optimal mucosal penetration, controlled release, high efficacy in inflamed vaginal conditions can improve HIV prevention in this target group. Key preformulation considerations must be taken to achieve optimal delivery of safe microbicides via the vaginal route and to further development of products in this category.