To evaluate adherence to a single dual-prevention pill (DPP) compared with a two-pill regimen (2PR) for pre-exposure prophylaxis (PrEP) and pregnancy prevention in women without HIV.

To evaluate adherence to a single DPP consisting of co-formulated Tenofovir Disoproxil Fumarate and Emtricitabine (FTC/TDF) plus combined ethinyl estradiol/levonorgestrel oral contraceptive (COC), compared with a two-pill regimen (2PR) consisting of daily oral FTC/TDF pill and combined COC pill, for pre-exposure prophylaxis PrEP and pregnancy prevention in women without HIV.

Inclusion Criteria:

• Age 16 through 39 years old (inclusive) at Screening.
• Adults must be able and willing to provide informed consent. Adolescents (16- and 17-year-olds) will be consented according to applicable local guidelines, by obtaining participant assent and where applicable parental or guardian permission.
• Able and willing to provide adequate locator information.
• Able and willing to comply with all study procedures.
• Must be post-menarche and pre-menopausal and could potentially become pregnant.
• Sexually active, defined as having had penile-vaginal sex within the 3 months before Screening (per self-report)
• Negative pregnancy test at Screening and Enrollment.
• Does not intend to become pregnant within the next 12 months.
• Willing to use COCs for at least 48 weeks as their method of contraception.
• HIV negative at Screening and Enrollment.
• Willing to use oral PrEP for at least 48 weeks.
• Hepatitis B (HBV) surface antigen (HbsAg) negative per blood test at Screening.
• Hepatitis C (HCV) negative at Screening.
• Normal estimated creatinine clearance (eCrCl) ≥ 60 ml/min per blood test at Screening.

Exclusion Criteria:

• Intolerance, adverse reaction, or laboratory abnormality associated with PrEP use in the past.
• Unable to become pregnant e.g., had a tubal ligation or hysterectomy or otherwise lacks a uterus, or is currently using another form of contraception.
• Medically ineligible for combined hormonal contraception and specifically COCs per World Health Organization (WHO) medical eligibility criteria for contraceptive use or similar local medical eligibility guidelines (e.g., Centers for Disease Control and Prevention eligibility criteria).
• Medically ineligible for PrEP based on WHO and/or local guidelines.
• Using or planning to use another pregnancy prevention product other than oral contraception (condoms are permitted) during the next 48 weeks.
• Using or planning to use another HIV prevention product other than condoms during the next 48 weeks.
• Any other condition the clinician feels would jeopardize the health and wellbeing of the participant

Women

For studies within two years of primary objective(s) publication, de-identified individual participant data that underlie results in a publication will be provided upon request. For studies more than two years from the primary objective(s) publication, de-identified datasets will be available upon request (Public Use Datasets).

Investigators may request de-identified datasets in order to duplicate published results, as required by specific journals. Otherwise, de-identified datasets will be made available upon request, two years following publication of the primary results manuscript.

Researchers aiming to duplicate published results or who provide a methodologically sound proposal for use of the data may submit a request for access to data that has informed published results by sending an email to HPTN-Data-Access@scharp.org. To access available de-identified datasets, investigators must complete the request form on the Atlas website. Researchers of approved requests will need to sign an HIV Prevention Trials Network (HPTN) Data Use Agreement before receiving the data and agree to use the provided acknowledgement statement.