Dapivirine Ring Design Guide - Human-Centered Design Research to Increase Uptake and Use

“No one product alone will end the epidemic. To end AIDS, women will need a range of options that meet their needs and fit within the context of their lives.”

This guide uses a human-centred design (HCD) approach to create design concepts and tools to increase the adoption and sustained use of the dapivirine (DPV) ring, the first long-acting woman-controlled method for reducing the risk of HIV infection. The guide was developed by the United States Agency for International Development (USAID)’s Office of HIV/AIDS (OHA) and USAID’s Center for Accelerating Innovation and Impact (CII) - along with the International Partnership for Microbicides (IPM), which sought to increase demand for the DPV ring and other HIV-prevention products. Increasing the demand for this HIV protection method was deemed crucial, as women and girls in sub-Saharan Africa are “disproportionately burdened by HIV/AIDS and account for nearly 60% of all HIV infections. Young women aged 15-24 are twice as likely to be infected than men of the same age. While a broad range of factors contribute to the vulnerability of young women in the region, a new generation of ‘women-initiated technologies’ has the potential to shift dynamics and give women more varied options to manage their own sexual health.”

To encourage use, young women need products that are designed with their values, needs, and lifestyle in mind. For that reason, the initiative outlined in this guide used the HCD approach to better understand the daily lives of at-risk young women. As explained in the guide, “a defining characteristic of the human-centered design process is that it prioritizes speaking and collaborating with the people who are most likely affected by the development of a new intervention, program, or product. For this project, the design team interviewed young women and their partners, healthcare providers, community leaders, and implementing partners. Researchers visited local communities, clinics, and young women’s homes and held workshops with young women and their influencers to understand the issues and concerns informing decisions about SRH [sexual and reproductive health], generally, and HIV prevention products, specifically. Insights from these activities informed design concepts. At each step, the design team engaged and solicited additional feedback from users, communities, and collaborators through rapid prototyping.”

The guide is intended for implementers, including public sector agencies, such as ministries of health and large non-profit organisations that specialise in healthcare delivery; donors and funders that fund interventions in SRH; healthcare providers who directly provide SRH information and services; and other stakeholders and partners, including manufacturers, suppliers, and governments.

The publication has two parts: (i) the guide, which gives an overview of design concepts and how they were developed through user research, journey mapping, and persona development; and (ii) a supplementary asset library, which provides resources, such as editable templates and supporting visuals for select concepts. These files provide a starting point for adapting existing concepts according to the needs of the communities and stakeholders served.

The guide contains the following sections:

1. Approach - This section takes the reader through the HCD methodology applied in this work, which includes a mix of user research through qualitative interviews, workshops, and prototyping with women aged 18–24 and their influencers in South Africa and Uganda. This work has built on insights from past sociobehavioural research in the microbicide field and will inform open-label extension studies, demonstration projects, and product launch planning for the DPV ring.
2. Journey & Insights - This section highlights key insights that shape the SRH journey of potential DPV ring users. These insights and subsequent personas serve as key jumping off points for the design concepts and strategies in Section Four.
3. User Personas - This section introduces stylised personas based on user research to illustrate the diverse range of responses to SRH experiences across the health journey.
4. Design Concepts - Design concepts are used to illustrate a wide range of opportunities to more effectively reach the intended user and support the adoption and sustained use of the SRH options that are right for her. These concepts were tested and validated with users and their influencers and encompass key elements of the experience - from communications to user tools to service delivery to community support. While the concepts in this guide are tailored to the DPV ring, they can be adapted for a broader range of programmes related to SRH.