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The purpose of this study is to compare tests of vaginal insertion of applicators(visual inspection of returned applicators (VIRA), inspection of returned applicators under ultraviolet (UV) light, and DNA/protein markers) to determine which, if any, warrant use in a clinical trial of a new vaginal microbicide. The study will also determine whether indicators of semen can be detected on applicators and the degree to which they correlate with reported intercourse, and the correlation between vaginal bacteria detected by a vaginal swab and those detected from the applicator. In addition, the study will determine whether several factors that may be encountered in a clinical trial are likely to affect detection of these markers, including storage for 30 days vs. 7 days, wiping applicators after use, the presence of gel, and inter- and intra-woman variability. The study will also assess safety.
Screening tests will be performed to detect exclusion criteria. After confirming the absence of point-of-care exclusion criteria, four applicators (#1 to 4, "sham" applicators) will be handled by the participant, but not inserted into the vagina and the gel will be expelled into a waste container. Four applicators (#5 to 8) will be inserted into the participant's vagina, one at a time, by the investigator, removed, and then the gel will be expelled into a waste container. Two applicators (#9 and 10) will be inserted into the participant's vagina, one at a time, and gel will be expelled into the participant's vagina. Finally, two applicators (#11 and 12) will be inserted into the participant's vagina, one at a time, by the investigator, removed and then the gel expelled into a waste container. Applicators #11 and 12 will then be wiped clean with a paper towel. Thus, each participant will provide a total of 12 applicators, half of which will be processed within one week of her visit and half of which will be processed in approximately one month of her visit. Three readers blinded to the status of the applicators (sham, inserted with or without gel expulsion) will determine, by VIRA and UV light assessment, whether or not the applicators were inserted vaginally. Additional laboratory personnel, who will also be blinded to the status of the applicators, will process the applicators for DNA and protein markers of product adherence and protocol compliance.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Healthy women |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| HEC placebo gel applicators | Other | Participants will handle, but not insert, 4 applicators containing HEC placebo gel. Participants will vaginally insert and removed 8 applicators containing HEC placebo gel. Gel will be expelled in to the vagina from only 2 applicators. |
| Measure | Description | Time Frame |
|---|---|---|
| Sensitivity, specificity, PPV, and NPV of the following indicator of vaginal insertion: VIRA | 7 days after insertion of vaginal applicators | |
| Number of applicators on which Y chromosome-associated genes can be detected and degree of correlation between detection and the number of days since last penile/vaginal intercourse | 7 days after insertion of vaginal applicators | |
| Degree of correlation of vaginal species obtained from vaginal applicators and vaginal species obtained from vaginal swabs | 7 days after insertion of vaginal applicators | |
| Sensitivity, specificity, PPV, and NPV of the following indicator of vaginal insertion: VIRA | 30 days after insertion of vaginal applicators | |
| Sensitivity, specificity, PPV, and NPV of the following indicator of vaginal insertion: UV Light Inspection | 7 days after insertion of vaginal applicators | |
| Sensitivity, specificity, PPV, and NPV of the following indicator of vaginal insertion: UV Light Inspection | 30 days after insertion of vaginal applicators | |
| Sensitivity, specificity, PPV, and NPV of the following indicator of vaginal insertion: DNA sequences of vaginal bacteria | 7 days after insertion of vaginal applicators | |
| Sensitivity, specificity, PPV, and NPV of the following indicator of vaginal insertion: DNA sequences of vaginal bacteria | 30 days after insertion of vaginal applicators |
| Measure | Description | Time Frame |
|---|---|---|
| Difference in detection of these markers when applicators are processed within one week versus approximately 30 days after the participant's visit | 30 days after insertion of vaginal applicators | |
| Difference in the sensitivity, specificity, NPV and PPV of detection of these markers when applicators are wiped off after removal from the vagina |
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Inclusion Criteria:
Exclusion Criteria:
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Healthy, non-pregnant, HIV-uninfected women
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| Name | Affiliation | Role |
|---|---|---|
| Andrea Thurman, M.D. | Clinical Research Center, Eastern Virginia Medical School, Norfolk, VA | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Clinical Research Center, Eastern Virginia Medical School | Norfolk | Virginia | 23507 | United States |
| Type | Date | Date Unknown |
|---|---|---|
| Release | Aug 21, 2015 | |
| Reset | Sep 22, 2015 | |
| Release | Jan 29, 2016 | |
| Reset | Feb 25, 2016 | |
| Release | Dec 7, 2016 | |
| Reset | Feb 1, 2017 | |
| Release | Mar 1, 2017 | |
| Reset | Apr 11, 2017 | |
| Release | Aug 23, 2017 | |
| Reset | Mar 22, 2018 | |
| Release | May 15, 2018 | |
| Reset | Dec 13, 2018 | |
| Release | Jan 29, 2019 | |
| Reset | May 1, 2019 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Aug 21, 2015 | Sep 22, 2015 | |||
| Jan 29, 2016 |
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| Sensitivity, specificity, PPV, and NPV of the following indicator of vaginal insertion: Immunohistochemical tests for protein markers | 7 days after insertion of vaginal applicators |
| Sensitivity, specificity, PPV, and NPV of the following indicator of vaginal insertion: Immunohistochemical tests for protein markers | 30 days after insertion of vaginal applicators |
| Number of applicators on which Y chromosome-associated genes can be detected and degree of correlation between detection and the number of days since last penile/vaginal intercourse | 30 days after insertion of vaginal applicators |
| Degree of correlation of vaginal species obtained from vaginal applicators and vaginal species obtained from vaginal swabs | 30 days after insertion of vaginal applicators |
| 7 days after insertion of vaginal applicators |
| Difference in detection of these markers when gel is present, either from a current applicator insertion and gel expulsion or from previous and current applicator insertion and gel expulsion | 7 days after insertion of vaginal applicators |
| Difference in the sensitivity, specificity, NPV and PPV of detection of these markers when applicators are wiped off after removal from the vagina | 30 days after insertion of vaginal applicators |
| Difference in detection of these markers when gel is present, either from a current applicator insertion and gel expulsion or from previous and current applicator insertion and gel expulsion | 30 days after insertion of vaginal applicators |
| Feb 25, 2016 |
| Dec 7, 2016 | Feb 1, 2017 |
| Mar 1, 2017 | Apr 11, 2017 |
| Aug 23, 2017 | Mar 22, 2018 |
| May 15, 2018 | Dec 13, 2018 |
| Jan 29, 2019 | May 1, 2019 |