The purpose of the study is to evaluate the safety of the TFV/LNG intravaginal ring (IVR), TFV-only IVR, and placebo IVR, evaluate pharmacokinetics (PK) of TFV and LNG, evaluate pharmacodynamic (PD) surrogates of contraceptive efficacy of LNG, and to evaluate acceptability of the IVRs.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
86
Eastern Virginia Medical School
Norfolk, Virginia, United States
Profamilia
Santo Domingo, Dominican Republic, Dominican Republic
Number of treatment-emergent adverse events
Number of treatment-emergent adverse events
Time frame: IVR Day 1, 2, ~8, ~16-18; 24 hours and 1-2 weeks post-IVR insertion and 1-2 weeks after IVR removal
Systemic laboratory tests
Changes in Systemic laboratory tests
Time frame: Baseline and IVR Day ~16-18
Cervicovaginal ulcerations, abrasions, edema, and other findings
Development of cervicovaginal ulcerations, abrasions, edema, and other findings as assessed by naked eye and colposcopic visualization of the cervicovaginal epithelium
Time frame: Baseline, IVR Day 2, ~8 and ~16-18
Soluble markers of innate mucosal immunity and inflammatory response in cervicovaginal lavage (CVL) fluid
Changes in soluble markers of innate mucosal immunity and inflammatory response in CVL fluid
Time frame: Baseline and IVR Day ~16-18
HIV-1 target immune cell phenotype and HIV-1 activation/proliferation marker in cervicovaginal tissue (biopsy)
Changes in HIV-1 target immune cell phenotype and HIV-1 activation/proliferation marker in cervicovaginal tissue (biopsy)
Time frame: Baseline and IVR Day ~16-18
Microflora (semi-quantitative vaginal culture and/or unculturable bacteria)
Changes microflora (semi-quantitative vaginal culture and/or unculturable bacteria)
Time frame: Baseline and IVR Day ~16-18
Vaginal pH
Changes in vaginal pH
Time frame: Baseline and IVR Day ~16-18
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Nugent Score
Changes in Nugent Score
Time frame: Baseline and IVR Day ~16-18
TFV concentrations in plasma
TFV concentrations in plasma
Time frame: Baseline; 1, 2, 4 and 8 hrs post-IVR insertion; IVR Day 2, ~8, ~16-18; 24 hours post-IVR removal
TFV concentrations in cervicovaginal fluid (aspirate and swab)
TFV concentrations in cervicovaginal fluid (aspirate and swab)
Time frame: 1, 2, 4 or 8 hours post-IVR insertion (randomized time point); IVR Day 2, ~8, ~16-18; 24 hours post-IVR removal
TFV concentrations in genital tissue (biopsy)
TFV concentrations in genital tissue (biopsy)
Time frame: IVR Day 2, ~16-18; 24 or 72 hours post-IVR removal (randomized time point)
Tenofovir diphosphate (TFV-DP) concentrations in peripheral blood mononuclear cells (PBMCs)
TFV-DP concentrations in PBMCs
Time frame: IVR Day ~16-18
TFV-DP concentrations in genital tissue (biopsy)
TFV-DP concentrations in genital tissue (biopsy)
Time frame: IVR Day 2, ~16-18; 24 or 72 hours post-IVR removal (randomized time point)
LNG concentration in blood (including SHBG)
LNG concentration in blood (including SHBG)
Time frame: Baseline; 1, 2, 4 and 8 hrs post-IVR insertion; IVR Day 2, ~8, ~16-18; 24 hours post-IVR removal
LNG concentration in vaginal secretions (swabs)
LNG concentration in vaginal secretions (swabs)
Time frame: Baseline; IVR Day~8
LNG concentration in cervical mucus
LNG concentration in cervical mucus
Time frame: IVR Day ~8, ~16-18; 24 hours post-IVR removal
Weight of returned IVRs
Weight of returned IVRs
Time frame: IVR Day ~16-18 (post-removal)
Amount of drug remaining in returned IVRs
Amount of drug remaining in returned IVRs
Time frame: IVR Day ~16-18 (post-removal)