Table 2.

Comparison of MPT delivery routes and formulations.

Delivery Route	Formulations	Advantages	Limitations	Considerations
Oral	Tablets	Convenient and easy to use Does not interfere with daily activities	Low patient adherence Extended release is difficult to achieve Solubility and absorption challenges Low gastric retention time Significant first-pass metabolism	Mucoadhesive materials Potent APIs Alter delivery architectures to enhance retention time
Parenteral	Implants Injectables	Sustained drug release Compatible with many APIs Injections are most accepted and have the highest adherence by South African women Does not interfere with daily activities Tunable system	Invasive surgery or large needles Implants need to be inserted or removed Injection site reactions Difficulties with reversibility or immediate withdrawal of the drug(s) Typically needs to be administered by a provider	Biodegradable materials Reversible or removable
Vaginal	Films Gels Tablets/Inserts	Convenient and easy to use Facile manufacturing	Extended release is difficult to achieve Difficulties with vaginal bioadhesion May interfere with daily activities Effectiveness is dependent on user adherence	Mucoadhesive materials Slow degrading and non-pH sensitive materials
	Intravaginal rings	Sustained drug release Tunable release kinetics Compatible with many APIs Significant drug uptake and absorption No need for pre-coitus action	Incomplete API release May interfere with intercourse Low user acceptability Limited material and design choices One size/one dose does not fit all Possibility of expulsion	Expand design space Reduce high temperature and pressure systems