Dual Prevention Pill

What is the Dual Prevention Pill (DPP)?

The Dual Prevention Pill (DPP) is currently being developed for daily use to prevent both HIV and pregnancy. It is one of several multipurpose prevention technologies (MPTs) – products designed to address multiple health needs in a single product – currently in development. The DPP is comprised of oral pre-exposure prophylaxis (PrEP) for HIV and a combined oral contraceptive (COC). Public and private initiatives developing the DPP are underway.

Why is the DPP important?

In East and Southern Africa, where the DPP is initially planned for introduction: 
  • 65 percent of new HIV infections in adults are amongst women aged 15 and over
  • 16 percent of women of reproductive age have an unmet need for contraception
As the youth bulge results in millions of young people entering their reproductive years, the potential benefits of the DPP are critical. Specifically, the DPP could increase uptake of oral PrEP among women in high-burden settings and improve adherence, as well as mitigate the stigma that women may feel when seeking HIV services alone. It could also lay the groundwork for the development and rollout of other MPTs currently in the research pipeline, such as vaginal rings, injectables and implants.

What is the status of the DPP?

A single tablet co-formulated to contain oral PrEP and COC is under development. Since both oral PrEP and COC are already approved for regular use and have been proven safe and efficacious on their own, these drugs will be further tested to determine if they are as safe and effective in combination, an approach formally known as a bioequivalence study. If the DPP exhibits comparable bioequivalence, the product developers will submit the DPP for review by regulatory authorities.

What is the DPP Project?

The DPP Project, initiated in August 2019, was formed to help rapidly and successfully  introduce a DPP for HIV and pregnancy prevention. A coalition of organizations, including AVAC, the Clinton Health Access Initiative (CHAI), Mann Global Health, Viatris and the Population Council, lead the DPP project. These efforts are supported by the Children’s Investment Fund Foundation (CIFF), the Bill & Melinda Gates Foundation (BMGF), the US Agency for International Development (USAID) and WCG Cares. Click here to learn more about the project.

The DPP Project’s Geographic Scope

Settings that demonstrate need (high HIV incidence and high unmet need for modern contraception), potential demand (current oral PrEP and contraceptive use) and enabling policy and regulatory environments will be prioritized for early DPP introduction. Early estimates indicate a potential market of 251,000-1.25 million women in 15 countries in sub-Saharan Africa. Kenya, South Africa and Zimbabwe are expected to be early introduction countries for the DPP.  

DPP Project Timeline

Key Resources

Overview Market Preparation and Introduction End-User Research Service Delivery

Contact Information

Please contact dpp@avac.org with any questions or requests related to this project.