{"id":56247,"date":"2022-09-08T07:01:07","date_gmt":"2022-09-08T11:01:07","guid":{"rendered":"https:\/\/www.psi.org\/?post_type=rwsi-blog&#038;p=56247"},"modified":"2022-11-14T17:42:49","modified_gmt":"2022-11-14T22:42:49","slug":"the-appeal-and-potential-of-on-demand-contraceptive-options","status":"publish","type":"rwsi-blog","link":"https:\/\/www.psi.org\/pt\/rwsi-blog\/the-appeal-and-potential-of-on-demand-contraceptive-options\/","title":{"rendered":"The appeal and potential of on-demand contraceptive options"},"content":{"rendered":"<p><\/p>\n\n\n<p><em><strong>By <a href=\"https:\/\/www.psi.org\/staff\/staff_type\/ashley-jackson\/#:~:text=Ashley%20Jackson%20is%20the%20Deputy%20Project%20Director%20for,report%20method-related%20reasons%20for%20non-use%20of%20family%20planning.\">Ashley Jackson<\/a>, Former Deputy Project Director, Expanding Effective Contraceptive Options, and L\u00e9once Dossou, Mass Media Communications, Sales, and Distribution Manager, L\u2019Association B\u00e9ninoise pour le Marketing Social et la Communication pour la Sant\u00e9<\/strong><\/em><\/p>\n\n\n\n<\/p>\n<p>P\u00e9niel, age 23,\u00a0and Val\u00e9rie, age 42,\u00a0both\u00a0use\u00a0contraception\u00a0\u2013\u00a0but only\u00a0when they\u00a0have sex.\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<p>\u201cI am not living with my man at the moment, but he comes over from time to time,\u201d\u00a0P\u00e9niel\u00a0shares.\u00a0\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<p>P\u00e9niel\u00a0didn\u2019t feel\u00a0like oral contraceptive pills and condoms\u00a0were right for her. She worried she would forget her pills, or that her partner would use a condom incorrectly.\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<p>For Val\u00e9rie too, sex happens intermittently. \u201cWhen my husband comes back from his travels,\u201d she explains. \u201cNot every day.\u201d\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<p>\u201cI was hesitant about other methods,\u201d\u00a0Val\u00e9rie\u00a0adds.\u00a0She\u00a0wants her contraception to be discreet,\u00a0easy to use,\u00a0non-hormonal,\u00a0and\u00a0without side effects.\u00a0\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<p>These women \u2013 like\u00a0the\u00a0<a href=\"https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/family-planning-contraception\" target=\"_blank\" rel=\"noreferrer noopener\">1.1 billion<\/a>\u00a0sexually active women globally who do not want to get pregnant\u00a0\u2013\u00a0need\u00a0options to prevent pregnancy\u00a0on their\u00a0own terms.\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<p>When\u00a0a\u00a0new\u00a0on-demand,\u00a0self-care contraceptive product first arrived in Benin,\u00a0P\u00e9niel\u00a0and\u00a0Val\u00e9rie\u00a0were among the first in their community to line up for the\u00a0<a href=\"https:\/\/www.psi.org\/project\/self-care\/how-a-new-self-care-product-is-meeting-womens-unique-needs-during-covid-19\/\" target=\"_blank\" rel=\"noreferrer noopener\">Caya\u00ae diaphragm<\/a>.\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<p><iframe title=\"On-demand contraception in Benin: Why do women want it?\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/rSMCpknNrxw?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen><\/iframe><\/p>\n<p>\n\n\n\n<\/p>\n<h4>\u00a0<\/h4>\n<h4>The Case for\u00a0On-Demand Contraception\u00a0\u00a0<\/h4>\n<p>\n\n\n\n<\/p>\n<p>Consumers need a\u00a0range of\u00a0effective\u00a0contraceptive options that meet their varied\u00a0preferences, including the preference for on-demand contraception\u2014especially\u00a0among\u00a0those who have infrequent sex.\u00a0\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<p>Globally, the two most common\u00a0<a href=\"https:\/\/reproductive-health-journal.biomedcentral.com\/articles\/10.1186\/s12978-019-0805-7\" target=\"_blank\" rel=\"noreferrer noopener\">reasons women give for not using contraception<\/a>\u00a0while in need are:\u00a0\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<ol class=\"wp-block-list\">\n<li>\u201c<strong>Health concerns<\/strong>,\u201d including health risks, fears of side effects, and unwanted menstrual changes.\u00a0\u00a0<\/li>\n<\/ol>\n<p>\n\n\n\n<\/p>\n<ol class=\"wp-block-list\" start=\"2\">\n<li>\u201c<strong>Infrequent sex<\/strong>.\u201d Women who are unmarried and those\u00a0who\u00a0do not have children are more likely than others\u00a0to say infrequent sex is why they do not use contraception.\u00a0\u00a0<\/li>\n<\/ol>\n<p>\n\n\n\n<\/p>\n<p>Across a wide range of countries,\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24835831\/\" target=\"_blank\" rel=\"noreferrer noopener\">studies<\/a>\u00a0have found an interest\u00a0in\u00a0on-demand options among women\u00a0who have infrequent sex, many of\u00a0whom\u00a0desire\u00a0convenience, ease of remembering,\u00a0the\u00a0ability to conceal use\u00a0and the avoidance of continuous exposure to contraceptive hormones and\/or side effects.\u00a0\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<p>But for consumers who want contraception only at or around the time of sex, what on-demand options\u00a0really\u00a0exist?\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<h4>The Narrow Range of Current\u00a0On-Demand\u00a0Options\u00a0<\/h4>\n<p>\n\n\n\n<\/p>\n<p>The range of\u00a0on-demand options\u00a0on the market\u00a0is\u00a0limited.\u00a0Only three options are widely available:\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<ul class=\"wp-block-list\">\n<li><strong>Withdrawal\u00a0<\/strong>is one of the most common traditional methods of family planning.\u00a0No product is needed.\u00a0However, this approach\u00a0is less effective than modern contraceptive methods.\u00a0<\/li>\n<li><strong>Male and female condoms\u00a0<\/strong>are the preferred\u00a0modern\u00a0methods for many. These non-hormonal barrier methods\u00a0provide protection against HIV and other sexually transmitted infections in addition to contraception. But condoms\u00a0do not satisfy the\u00a0entire\u00a0universe of consumers with\u00a0a desire for on-demand contraception.\u00a0Many consumers\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6018458\/\" target=\"_blank\" rel=\"noreferrer noopener\">report<\/a>\u00a0they do not use condoms due to dislike of the physical sensation of use, social stigma,\u00a0lack of male partner support,\u00a0and other reasons.\u00a0<\/li>\n<li><strong>Emergency contraceptive pills (ECPs)\u00a0<\/strong>can be taken up to 5 days after sex. (The sooner they are taken, the more likely they are to be effective.)\u00a0Unlike other modern methods,\u00a0ECPs do\u00a0not need to be accessed before sex\u2014making this method\u00a0particularly valuable when sex is unplanned.\u00a0Yet some consumers, like\u00a0Val\u00e9rie, desire a non-hormonal option.\u00a0In addition, regular use of ECPs is not yet authorized by\u00a0national regulatory authorities.\u00a0\u00a0\u00a0\u00a0<\/li>\n<\/ul>\n<p>\n\n\n\n<\/p>\n<h3>\u00a0<\/h3>\n<h3>Might\u00a0new\u00a0on-demand contraceptive methods fill a market gap?\u00a0<\/h3>\n<p>\n\n\n\n<\/p>\n<h4>Options on the Horizon\u00a0\u00a0<\/h4>\n<p>\n\n\n\n<\/p>\n<p>Research shows that on-demand options have enormous potential to respond to consumer preferences. Yet of the\u00a0USD\u00a0$64 million spent globally on contraceptive technology development in 2018, just $3.7 million (5.7\u00a0percent) went to on-demand methods,\u00a0according to the\u00a0<a href=\"https:\/\/www.policycuresresearch.org\/analysis\/\" target=\"_blank\" rel=\"noreferrer noopener\">2020 G-FINDER Report<\/a>.\u00a0\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<p>Three on-demand methods\u00a0have the potential to become more widely available by 2025:\u00a0\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<ul class=\"wp-block-list\">\n<li><strong>Pericoital\u00a0oral contraception\u00a0<\/strong>could\u00a0address a need\u00a0for women who want\u00a0the\u00a0option\u00a0to\u00a0use\u00a0a contraceptive pill\u00a0before or after sex, as needed.\u00a0A\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24835831\/\" target=\"_blank\" rel=\"noreferrer noopener\">review of 19 studies<\/a>\u00a0in 16 countries found substantial interest among women in a\u00a0pericoital\u00a0pill that could be taken repeatedly.\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4755445\/\" target=\"_blank\" rel=\"noreferrer noopener\">Research<\/a>\u00a0by the World\u00a0Health Organization supports the safety and efficacy of this use of LNG 1.5 mg pills, the same formulation of many current ECPs,\u00a0multiple times within a menstrual cycle. Furthermore, recent (pre-published) research in Ghana and Kenya showed demand and high satisfaction with this method. Discussions are underway with regulatory bodies about the possibility of authorization of this method.\u00a0\u00a0\u00a0<\/li>\n<li><strong>Vaginal contraceptive gels,\u00a0<\/strong>such as\u00a0spermicidal gels,\u00a0can be\u00a0self-inserted\u00a0in the vagina\u00a0before\u00a0sex\u00a0to stop fertilization.\u00a0A\u00a0new\u00a0type of\u00a0gel\u00a0may enter more markets soon:\u00a0<a href=\"https:\/\/www.phexxi.com\/\" target=\"_blank\" rel=\"noreferrer noopener\">Phexxi\u00ae<\/a>, which\u00a0prevents pregnancy\u00a0by maintaining vaginal pH,\u00a0received\u00a0U.S. Food &amp; Drug Administration (FDA) approval in 2020.\u00a0<\/li>\n<\/ul>\n<p>\n\n\n\n<\/p>\n<ul class=\"wp-block-list\">\n<li><strong>Diaphragms\u00a0<\/strong>are a barrier method placed<strong>\u00a0<\/strong>over\u00a0the\u00a0cervix during sex.\u00a0<a href=\"https:\/\/www.caya.us.com\/?gclid=CjwKCAjw-ZCKBhBkEiwAM4qfF8rVCSLCfkzZCmOD0BCoW3g2-Aqw0lnowQdZ_w5TV5ERqLHK2D5tqhoCoLkQAvD_BwE\" target=\"_blank\" rel=\"noreferrer noopener\">Caya\u00ae<\/a>\u00a0departs from past diaphragms\u00a0primarily\u00a0because it comes in a single size,\u00a0meaning it\u00a0requires no fitting by a provider. With approvals by Stringent Regulatory Authorities and\u00a0several dozen\u00a0other\u00a0countries,\u00a0including three\u00a0in sub-Saharan Africa\u00a0(Benin, Niger, and Nigeria),\u00a0Caya access may soon increase\u2014including in countries that have never had widespread diaphragm access.\u00a0\u00a0<\/li>\n<\/ul>\n<p>\n\n\n\n<\/p>\n<p><strong><em>EECO and Knowledge SUCCESS curated a\u00a0collection of\u00a0<\/em><\/strong><a href=\"https:\/\/view.ceros.com\/johns-hopkins-ccp\/20-essential-resources-contraceptive-product-introduction\/p\/1\" target=\"_blank\" rel=\"noreferrer noopener\"><strong><em>20\u00a0Essential\u00a0Resources for\u00a0Contraceptive\u00a0Product\u00a0Introduction<\/em><\/strong><\/a><strong><em>. The selected resources\u00a0can support efforts by program planners and implementers to bring to market the new contraceptive products that consumers want, including on-demand options.\u00a0<\/em><\/strong>\u00a0<\/p>\n<h4>Peniel and Valerie&#8217;s Choice: A Single-Size Diaphragm\u00a0\u00a0<\/h4>\n<p>\n\n\n\n<\/p>\n<p>\u201cWhen\u00a0he\u00a0comes\u00a0over\u00a0and I\u2019m\u00a0ovulating, I\u00a0use Caya\u00a0to prevent pregnancy\u00a0for now,\u201d\u00a0P\u00e9niel\u00a0says.\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<p>In Benin and Niger, EECO\u00a0project monitoring and\u00a0user research\u00a0have\u00a0found that infrequent sex and a preference for on-demand contraception motivated\u00a0many women\u00a0like\u00a0P\u00e9niel\u00a0and\u00a0Val\u00e9rie\u00a0to choose\u00a0the\u00a0Caya\u00a0diaphragm.\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<p>P\u00e9niel and Val\u00e9rie accessed the Caya diaphragm through USAID\u2019s Expanding Effective Contraceptive Options (EECO) project, which leads pilot introductions of promising contraceptive methods. Through EECO, PSI\u2019s network member in Benin, the <em>Association\u00a0B\u00e9ninoise\u00a0pour le Marketing Social et la Communication pour la\u00a0Sant\u00e9<\/em>\u00a0(ABMS), supports providers to offer Caya alongside a wide range of contraceptive options.\u00a0\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<p>ABMS communicates with women and men about the possibility of pairing Caya with the fertility awareness-based Standard Days Method, which is available in the same clinics\u00a0that offer Caya.\u00a0On fertile days, some clients choose to use Caya rather than\u00a0abstaining\u00a0or using condoms.\u00a0\u00a0\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<p>To\u00a0address unmet need among\u00a0consumers\u00a0who have infrequent sex\u00a0and are dissatisfied with current contraception options,\u00a0there\u2019s more work to do.\u00a0When\u00a0pharmaceutical companies and\u00a0donors\u00a0invest in\u00a0developing\u00a0novel on-demand\u00a0methods\u00a0and\u00a0when we collectively increase consumer\u00a0access to\u00a0available\u00a0products, we put\u00a0the power of choice into\u00a0the hands of consumers like\u00a0P\u00e9niel\u00a0and Val\u00e9rie.\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<p>\u201c[Caya] is a very easy method\u00a0to use,\u201d Val\u00e9rie explains. \u201cIt\u2019s discreet\u2026 practical,\u00a0and\u00a0without side effects and hormones.\u201d\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<p>Simply,\u00a0it\u2019s\u00a0contraception on her terms.\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<p><em>For more information, please contact Ashley Jackson (<\/em><a href=\"mailto:ajackson@psi.org\" target=\"_blank\" rel=\"noreferrer noopener\"><em>ajackson@psi.org<\/em><\/a><em>).\u00a0<\/em>\u00a0<\/p>\n<p>\n\n\n\n<\/p>\n<p>\n\n\n<p><\/p>","protected":false},"excerpt":{"rendered":"<p>By Ashley Jackson, Former Deputy Project Director, Expanding Effective Contraceptive Options, and L\u00e9once Dossou, Mass Media Communications, Sales, and Distribution Manager, L\u2019Association B\u00e9ninoise pour le Marketing Social et la Communication pour la Sant\u00e9 P\u00e9niel, age 23,\u00a0and Val\u00e9rie, age 42,\u00a0both\u00a0use\u00a0contraception\u00a0\u2013\u00a0but only\u00a0when they\u00a0have sex.\u00a0 \u201cI am not living with my man at the moment, but he comes [&hellip;]<\/p>\n","protected":false},"featured_media":56249,"template":"","meta":[],"class_list":["post-56247","rwsi-blog","type-rwsi-blog","status-publish","has-post-thumbnail","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.psi.org\/pt\/wp-json\/wp\/v2\/rwsi-blog\/56247","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.psi.org\/pt\/wp-json\/wp\/v2\/rwsi-blog"}],"about":[{"href":"https:\/\/www.psi.org\/pt\/wp-json\/wp\/v2\/types\/rwsi-blog"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.psi.org\/pt\/wp-json\/wp\/v2\/media\/56249"}],"wp:attachment":[{"href":"https:\/\/www.psi.org\/pt\/wp-json\/wp\/v2\/media?parent=56247"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}