When designing contraceptives and HIV protection, Lisa Rohan’s lab considers the consumer
The email appeared, as nearly identical versions do every day, in Dr. Lisa Rohan’s inbox. Yet another person was looking to pick her brain on an age-old question: what do women want?
As the head of a product development lab that functions as a de facto mini biotech company within Magee-Womens Research Institute, Rohan has spent the better part of two decades asking that same question, even when few other people were.
What products will convince a woman to use a contraceptive when the very subject is culturally taboo? How can a woman protect herself from HIV infection in the part of the world where the risk is highest, but her partner might subject her to violence or separate her from her children if he finds out? How can you convince a woman worried about herpes to use a product that will help her?
The answers are as complex and individualized as the women the products serve; no one solution exists for any given situation. But that, Rohan argues, is why more research needs to focus on product development that takes all these factors into account.
“Women need options,” she says. “There is no magic bullet. We target all women. We try to think about all women. But we recognize that there are women with certain limitations either in their life, or in their economic status, or in their freedom to choose for themselves. So we try to consider all of these factors in developing products.”
A onetime engineer in the private pharmaceutical industry, Rohan was drawn to academia 20 years ago after completing a postdoctoral fellowship at MWRI. She remembers Dr. Sharon Hillier — then a mentor, now a colleague — suggesting that she write a review paper about women’s health.
“When I realized the lack of available scientific data in this area, I became very alarmed,” Rohan says. “Sharon knew that. But she sent me on the task to open my eyes to this deficiency. Recognizing the lack of available information sparked my passion and determination to work in this field.”
It was a pivotal moment, one that helped convince Rohan to forego the offers she had to return to private industry and focus instead on some of the most understudied problems in health care research.
“My experiences in the pharmaceutical industry did not expose me to women’s health issues. At that time, women were rarely even included in clinical trials. We have come a long way since then,” recalls Rohan. “My experiences — and the mentors and colleagues that I have had the opportunity to interact with here — have really opened my eyes to the need for more research in the area of women’s health.”
Currently, her lab juggles about 13 different grants, and to date has developed several products through phase 1 clinical trials, which are the first step of testing them in human patients for safety and efficacy. Apart from HIV and contraception, the lab also has worked in gynecologic oncology, general vaccines, evaluation of intrauterine devices, irritable bowel disease, and periodontal disease.
Rohan compares her lab to a mini biotech company which is unique to academics. “We have the experience and capability to advance development of pharmaceutical products from drug discovery to clinical trial initiation. This capacity is quite exceptional in an academic lab setting.”
When developing products, even something as simple as shampoo, scientists and engineers rely on feedback from behaviorists to determine what works and what doesn’t. For Rohan, the consumer information can make or break a woman’s ability to protect herself. A microbicide gel might be effective in stopping HIV infection, for example, but if it is detectable to her partner, or the applicator can be spotted in the household waste of a multifamily dwelling where such subjects are taboo, the woman probably won’t use it.
Yet HIV continues to pose a significant public health crisis worldwide. In sub-Saharan Africa, where infection rates are highest, women still count for a majority of the cases; numbers are rising in the 15-24 age group.
In developing products to combat the rising rates, Rohan and Hillier collaborate with several experts in the science of decision making. Among them are social psychology professor Julie Downs at Carnegie Mellon University; Ariane van der Straten, senior fellow at RTI International; and Kate Guthrie, professor of psychiatry and human behavior at Brown University.
To arrive at the answers they seek, they go straight to the source: women themselves. Some have practiced using the products with dummy body parts to offer feedback on ease of use. Some have actually had sex in the clinic and given opinions, as did their partners. Groups of women in Africa tried products for a week and reported back on what they liked and disliked. In a study in Pittsburgh, women were queried regarding opinions about product preference with respect to size, shape, and texture.
“It just makes common sense to me. If we’re going to build something for someone, we have to understand what they want,” Rohan says. “We can make great drugs, but if people won’t use them, they’ll never work.”
Current grants include development of a dissolving strip of film that would allow women to administer both contraceptives and HIV-fighting microbicides with a single product. These film products have been designed for not only on-demand use but also as products which can be administered less frequently (weekly or monthly).
Rohan stays in touch with her former colleagues in private industry. She serves as an advisor to a number of groups developing pharmaceutical products. And, of course, there are frequent calls and emails from companies that want to develop products for women.
“I talk to every single one of them. Because if I can educate and help them to design a better product for women, that’s a service that gives me immense satisfaction,” says Rohan. “I think we’ve only just begun to give women’s health the attention that it deserves. I’m here to not only contribute to the science but hope to also train and spark passion for women’s health research in the next generation of scientists. In the end, women’s health care needs: much more resources, much more effort, and much more thought put into it.”
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