Development of Adherence Biomarkers for Multiple Microbicide and Multipurpose Prevention Technology (MPT) Dosage Forms
Condition: HIV
Study type: Interventional
Phase: Phase 1

Summary: 
      The purpose of this study is to develop markers for use of placebo vaginal products and
      measure markers of mucosal semen exposure among healthy women. The study will also monitor
      safety of placebo product use.
    

Detailed description: 
      This is a Phase I, non-randomized, open label study in healthy, non-pregnant, HIV negative
      women, who are not at risk of pregnancy, and are at low risk for STIs (sexually transmitted
      infections). Participants will be assigned to use one of four placebo products: IVR
      (intravaginal ring) (approximately 20 participants), and vaginal insert, film or HEC
      universal placebo gel (approximately 10 participants each). Each woman will provide
      pre-product use vaginal swabs. Participants assigned to vaginal insert, film or gel will use
      products with and without timed intercourse with their male partner for a total of two doses
      of the product, will provide vaginal swabs post product use, and will be seen over 4 visits.

      Participants assigned to IVR do not have to be sexually active with a male partner. IVR
      assigned participants will use a total of 3 IVRs, one at a time. IVR assigned participants
      will use the first IVR (IVR1) for approximately 24 - 36 hours (no exposure to semen during
      IVR1 use). IVR assigned participants will use a second IVR (IVR2) for approximately 7 - 10
      days and a third IVR (IVR3) for approximately 28 - 32 days. During the use of IVR2 and IVR3,
      participants may engage in sexual intercourse, but it is not required. Women assigned to IVR
      use will be seen over 5 visits.

      Once a woman completes the study cycle with one study product, she may elect to do another
      cycle using a different product after a wash-out period of at least 7 days, if she can comply
      with study product specific protocol requirements. She may elect to do up to four cycles,
      each with a different study product. For each cycle, V1 screening procedures will be repeated
      as indicated by symptoms and or participant history, as assessed by the investigator and as
      outlined in the study manual. If re-screening procedures are not indicated, the new cycle may
      start with Visit 2 (V2).

      At Visit 1 (V1), volunteers will be consented and undergo procedures to confirm they are
      eligible to continue in the study. Participants will be counseled to refrain from vaginal
      activity, as applicable, for 48 hours prior to V2.

      V2 should occur on days 3 - 10 of the menstrual cycle, or for participants who do not have
      regular menstrual cycles, when the participant is not having heavy menstrual bleeding. Once
      it has been confirmed that the participant meets all of the inclusion criteria and none of
      the exclusion criteria, baseline pre-product use vaginal swabs will be taken. Participants
      will be required to refrain from any vaginal activity until after Visit 3 (V3).

        -  Participants assigned to gel, film or insert, will insert one dose (Dose 1) vaginally in
           the clinic. Vaginal swabs will be obtained in the clinic approximately 15 minutes after
           product use. Participants will be given vaginal swabs for home use. Participants will be
           instructed to obtain vaginal swabs, at bedtime daily, for 7 days, starting at the first
           bedtime after V2. Vaginal swabs will be stored in the participant's refrigerator and
           returned to the clinic at V3. V3 will occur 7 - 10 days after V2.

        -  For participants assigned to the IVR, the IVR1 will be inserted by the participant in
           the clinic. The participant will leave IVR1 in place until V3, which will occur 24 - 36
           hours after V2.

      At V3:

        -  Participants assigned to gel, film or insert will return used vaginal swabs to the
           clinic. Additional vaginal swabs will be obtained in the clinic. Participants will
           vaginally insert one dose of their assigned product (Dose 2) in the clinic. Vaginal
           swabs will be obtained in the clinic approximately 15 minutes after product use. The
           participants will be instructed to have vaginal intercourse with her male sexual partner
           within approximately 12 hours (± 4 hours) after insertion of the product. They will
           obtain vaginal swabs, at bedtime daily, for 7 days, starting at the first bedtime after
           V3 and after timed intercourse, as above. Participants will be instructed to refrain
           from additional acts of vaginal intercourse or other vaginal activity until Visit 4
           (V4). Vaginal swabs will be stored in the participant's refrigerator and returned to the
           clinic at V4. V4 will occur 7 - 10 days after V3.

        -  For participants assigned to the IVR, IVR1 will be removed at this visit. Post IVR1 use
           vaginal swabs will be obtained in the clinic. The second IVR (IVR2) will be inserted by
           the participant in the clinic. The participant will be instructed to leave the IVR2 in
           place until V4, which will occur 7 - 10 days after V3. IVR Participants may have vaginal
           intercourse (not required) during the use of IVR2 but should not have any other vaginal
           activity during the use of IVR2.

      At V4:

        -  Participants assigned to gel, film or insert will return used vaginal swabs to the
           clinic. Additional vaginal swabs will be obtained in the clinic. Participants will be
           exited from the study at this visit or they may elect to use a different study product.

        -  For participants assigned to the IVR, IVR2 will be removed at this visit. Post IVR2 use
           vaginal swabs will be obtained in the clinic. The third IVR (IVR3) will be inserted by
           the participant in the clinic. The participant will leave IVR3 in place until Visit 5
           (V5), which will occur 28 - 32 days after V4. Participants may have vaginal intercourse
           (not required) during the use of IVR3 but should not have any other vaginal activity
           during the use of IVR3.

      At V5 (For IVR only):

      • IVR3 will be removed at this visit. Post IVR3 use vaginal swabs will be obtained in the
      clinic. Participants will be exited from the study at this visit or they may elect to use a
      different study product.
    

Intervention name(s): HEC Placebo gel; Placebo Intravaginal Ring; Placebo Vaginal Film; Placebo Vaginal Insert
Intervention type(s): Other; Other; Other; Other
Allocation: Non-Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)