TY - JOUR T1 - Estimating the market size for a dual prevention pill: adding contraception to pre-exposure prophylaxis (PrEP) to increase uptake JF - BMJ Sexual & Reproductive Health JO - BMJ Sex Reprod Health DO - 10.1136/bmjsrh-2020-200662 SP - bmjsrh-2020-200662 AU - Lorna Begg AU - Rebecca Brodsky AU - Barbara Friedland AU - Sanyukta Mathur AU - Jim Sailer AU - George Creasy Y1 - 2020/07/31 UR - http://jfprhc.bmj.com/content/early/2020/07/31/bmjsrh-2020-200662.abstract N2 - Introduction Uptake of oral pre-exposure prophylaxis (PrEP) remains low. The objective of this analysis was to estimate the potential market size in priority sub-Saharan African countries for a 28-day dual prevention pill (DPP) regimen containing the active pharmaceutical ingredients in oral PrEP and oral contraceptive pills (OCPs) for the prevention of HIV and unintended pregnancy.Methods We selected 15 countries in sub-Saharan Africa for analysis. Population estimates were based on United Nations Population Division data from 2017. Low, medium and high rates (range 0.25% to 25%) of estimated conversion from current contraceptive method to the DPP were applied by country based on HIV prevalence (≥10% vs <10%), current contraceptive method (OCP, condom or unmet need for contraception) and age group (15–24 or 25–49 years).Results In these 15 countries, between 250 000 and 1.25 million women could switch from their current contraceptive method to the DPP. Given that current PrEP use in the 15 countries combined is estimated to be 113 250 (women and men), the most conservative market size estimate would more than double the number of women currently using PrEP.Conclusions By leveraging the existing market for OCPs and assuming modest conversion from condom users and women with an unmet need for contraception, the DPP could lead to a 2- to 10-fold increase in PrEP usage in these 15 sub-Saharan African countries, expanding the broader public health benefit of this proven HIV prevention strategy. ER -