Dual Prevention Pill

Last Updated: 9 March 2023

The Dual Prevention Pill (DPP) is currently being developed by public and private initiatives for daily use to prevent both HIV and pregnancy. It is one of several multipurpose prevention technologies (MPTs) – a single product designed to address multiple health needs – in the pipeline. The DPP combining TDF/FTC-based oral PrEP with oral contraceptives (OC) is furthest along in development. Another DPP combining F/TAF with OC is also in development.

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?

Since both oral PrEP and OC 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 as a co-formulated single tablet. This testing is known as a bioequivalence study. If the combined drugs in the DPP behave similarly in the body as they do when taken separately, the product developers will submit the DPP for review by regulatory authorities.

The DPP Project

Initiated in August 2019, the DPP Project was formed to accelerate the development and introduction of an MPT for HIV and pregnancy prevention.

A coalition of organizations, including AVAC, the Clinton Health Access Initiative (CHAI), Mann Global Health, Viatris, the Population Council, and Medicines360 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), Catalyst Global, and the HIV Prevention Trials Network (HPTN). Click here to learn more about the project.

The DPP Project’s Geographic Scope

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