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HIV PreventionNCT03671239

Rectal Microbicide Acceptability, Tolerability and Adherence

A study of HIV Prevention, run by Microbicide Trials Network at 7 sites in 5 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

MTN-035 is a multi-site, randomized-sequence, three-period, open label crossover study that will enroll approximately 210 participants randomized (1:1:1:1:1:1) to one of six sequences of rectal microbicide placebo product application. Read more about this study

Who is it for?
Ages 18 to 35 yearsHealthy volunteers can take part
Conditions the study is for
HIV Prevention
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
217 participants
Where
7 sitesin 5 countries
Study dates
26 Apr 2019to 27 Jul 2020
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 35 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Men (cis or transgender) and TGW who are 18-35 years old at Screening, verified per site SOP.
  • Able and willing to provide written informed consent.
  • HIV-1/2 uninfected at Screening and Enrollment, per applicable algorithm in Appendix II and willing to receive HIV test results.
  • Able and willing to provide adequate locator information, as defined in site SOP.
  • Available to return for all study visits and willing to comply with study participation requirements.
  • In general good health at Screening and Enrollment, as determined by the site Investigator of Record (IoR) or designee.
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  • At Screening, history of consensual RAI at least three times in the past three months and expecting to maintain at least this frequency of RAI during study participation per participant report.
  • Willing to not take part in other research studies involving drugs, medical devices, genital or rectal products, or vaccines for the duration of study participation (including the time between Screening and Enrollment).
  • For individuals who can get pregnant (i.e., TGM with a female reproductive system): a negative pregnancy test at Screening and Enrollment.
  • For individuals who can get pregnant: Per participant report at Enrollment, using an effective method of contraception for at least 30 days (inclusive) prior to Enrollment and intending to use an effective method for the duration of study participation; effective methods include:
  • Hormonal methods;
  • Intrauterine device (IUD) inserted at least 30 days prior to Enrollment (but not past the maximum length of recommended usage according to package instructions);
  • Sterilization (of participant or, if in a monogamous relationship, of partner, as defined in site SOPs);
  • Abstinence from RVI for 90 days prior to Enrollment, and intention to abstain from RVI for the duration of study participation.

Who cannot join

  • At Screening:
  • History of inflammatory bowel disease;
  • Current anorectal condition that would impede product placement or assessment of tolerability by participant report or exam.
  • Anticipated use and/or unwillingness to abstain from using non-study rectally-administered medications and products during study participation, including personal lubricants containing nonoxynol-9 (N-9).
  • Note: The use of non-study personal lubricants and usual pre-RAI douches that do not contain N-9 is permitted during study participation.
  • Known adverse reaction to any of the components of the study products.
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  • Participation in research studies involving drugs, medical devices, genital products, or vaccines within 30 days of the Enrollment Visit.
  • Participation in research studies involving rectal products (ever).
  • Per participant report, use of post-exposure prophylaxis (PEP) for potential HIV exposure within the 3 months prior to Enrollment.
  • In the 3 months prior to Enrollment, participant engagement in condomless RAI or RVI while not on PrEP with a partner who is HIVpositive and either not on ART or of unknown ART use status (by self report).
  • In the month prior to Enrollment, participant engagement in condomless RAI or RVI while not on PrEP with a partner who is of unknown HIV status and unknown PrEP/ART use status (by self-report).
  • Non-therapeutic injection drug use in the 12 months prior to Enrollment.
  • At either Screening or Enrollment, participant-reported symptoms and/or clinical or laboratory diagnosis of active anorectal or reproductive tract infection (RTI) requiring treatment per current WHO guidelines (http://www.who.int/hiv/ pub/sti/pub6/en/), or symptomatic urinary tract infection (UTI). Infections requiring treatment include: Neisseria gonorrhea (GC), Chlamydia trachomatis (CT), syphilis, active herpes simplex virus (HSV) lesions, anogenital sores or ulcers, or symptomatic genital warts, chancroid, pelvic inflammatory disease (PID), symptomatic bacterial vaginosis (BV), symptomatic vaginal candidiasis, and trichomoniasis.
  • Note: Otherwise eligible participants with a symptomatic UTI or an STI/RTI requiring treatment per current WHO guidelines may be retested during the screening process and if treatment is completed and symptoms have resolved within the screening window the participant may be enrolled.
  • Note: HSV-1 or HSV-2 seropositive diagnosis with no active lesions is permitted since treatment is not required.
  • For individuals who can get pregnant: Pregnant or breastfeeding at either Screening or Enrollment or planning to become pregnant during study participation.
  • For individuals who can get pregnant: Last pregnancy outcome 90 days or less prior to Screening.
  • Has any other condition that, in the opinion of the IoR/designee, would preclude informed consent, make study participation unsafe, complicate interpretation of study outcome data, or otherwise interfere with achieving study objectives.

Trial locations and contacts

7 sites in 5 countries.

7 sites in 5 countries

United States3 sites
  • Alabama Clinical Research Site

    Birmingham, Alabama, 35294

  • University of Pittsburgh Clinical Research Site

    Pittsburgh, Pennsylvania, 15216

  • Bridge HIV Clinical Research Site

    San Francisco, California, 94102

Other trials in United States

Malawi1 site
  • Blantyre Clinical Research Site

    Blantyre

Other trials in Malawi

Peru1 site
  • San Miguel Clinical Research Site

    San Miguel, 15088

Other trials in Peru

South Africa1 site
  • Wits Reproductive Health and HIV Institute Clinical Research Site

    Johannesburg, 2038

Other trials in South Africa

Thailand1 site
  • Chiang Mai University HIV Prevention Clinical Research Site

    Chiang Mai, 50202

Other trials in Thailand

About this study

Official title: Acceptability, Tolerability, and Adherence of Three Rectal Microbicide Placebo Formulations Among HIV Seronegative Cisgender Men, Transgender Men and Transgender Women Who Engage in Receptive Anal Intercourse

MTN-035 is a multi-site, randomized-sequence, three-period, open label crossover study that will enroll approximately 210 participants randomized (1:1:1:1:1:1) to one of six sequences of rectal microbicide placebo product application.

Read the detailed description

MTN-035 is a multi-site, randomized-sequence, three-period, open label crossover study that will enroll approximately 210 participants randomized (1:1:1:1:1:1) to one of six sequences of rectal microbicide placebo product application. At the start of each 4-week product use period, participants will receive either rectal inserts, rectal douches, or rectal suppositories and be instructed to use their assigned study product prior to each receptive anal intercourse (RAI) encounter during that period. Participants who do not have RAI in a given week will be asked to use the product without sex. There will be a 1-week washout period between each of the three product use periods. Participant follow-up will take approximately 3.5 months.

Conditions
HIV Prevention
Being tested
Placebo rectal insert, Placebo rectal suppository, Placebo rectal douche
Keywords
Acceptability, Rectal microbicide

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Placebo rectal insertBehavioural

    Participants will be instructed to insert in the rectum a placebo insert prior to RAI. If a dose is missed, participants will be instructed to wait to take a dose at the next occurrence of RAI. Furthermore, if no RAI activity occurs at all in a given 7-day period, participants will be instructed to take a dose on the seventh day in the absence of RAI.

  • Placebo rectal suppositoryBehavioural

    Participants will be instructed to insert in the rectum a placebo suppository prior to RAI. If a dose is missed, participants will be instructed to wait to take a dose at the next occurrence of RAI. Furthermore, if no RAI activity occurs at all in a given 7-day period, participants will be instructed to take a dose on the seventh day in the absence of RAI.

  • Placebo rectal doucheBehavioural

    Participants will be instructed to insert in the rectum a placebo douche (enema bottle with approximately 120 mL of clean tap water or bottled water) prior to RAI. If a dose is missed, participants will be instructed to wait to take a dose at the next occurrence of RAI, or if no other RAI activity occurs in that 7-day period, to take a dose in the absence of RAI. Furthermore, if no RAI activity occurs at all in a given 7-day period, participants will be instructed to take a dose on the seventh day in the absence of RAI.

Study groups in NCT03671239
Study groupRoleWhat they receive
Product Sequence AOtherParticipants will use placebo rectal inserts during the first 4-week product use period, placebo rectal douches during the second 4-week product use period, and placebo rectal suppositories during the third and final 4-week product use period.
Receives: Behavioral: Placebo rectal insert; Behavioral: Placebo rectal suppository; Behavioral: Placebo rectal douche
Product Sequence BOtherParticipants will use placebo rectal douches during the first 4-week product use period, placebo rectal suppositories during the second 4-week product use period, and placebo rectal inserts during the third and final 4-week product use period.
Receives: Behavioral: Placebo rectal insert; Behavioral: Placebo rectal suppository; Behavioral: Placebo rectal douche
Product Sequence COtherParticipants will use rectal suppositories during the first 4-week product use period, rectal inserts during the second 4-week product use period, and rectal douches during the third and final 4-week product use period.
Receives: Behavioral: Placebo rectal insert; Behavioral: Placebo rectal suppository; Behavioral: Placebo rectal douche
Product Sequence DOtherParticipants will use placebo rectal inserts during the first 4-week product use period, placebo rectal suppositories during the second 4-week product use period, and placebo rectal douches during the third and final 4-week product use period.
Receives: Behavioral: Placebo rectal insert; Behavioral: Placebo rectal suppository; Behavioral: Placebo rectal douche
Product Sequence EOtherParticipants will use placebo rectal douches during the first 4-week product use period, placebo rectal inserts during the second 4-week product use period, and placebo rectal suppositories during the third and final 4-week product use period.
Receives: Behavioral: Placebo rectal insert; Behavioral: Placebo rectal suppository; Behavioral: Placebo rectal douche
Product Sequence FOtherParticipants will use placebo rectal suppositories during the first 4-week product use period, placebo rectal douches during the second 4-week product use period, and placebo rectal inserts during the third and final 4-week product use period.
Receives: Behavioral: Placebo rectal insert; Behavioral: Placebo rectal suppository; Behavioral: Placebo rectal douche

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Acceptability of Future Product Use

    Using a 10-point scale (1=Very Unlikely; 10=Very Likely), participants were asked to answer the following question about their most recently used product: "Think about the positive and negative experiences you have had using the [study product] during the past 4-week period. If this [study product] was available and it provided some protection against HIV, how likely would you be to use it before receptive anal sex?". The endpoint was operationalized as binary, with scores 1 to 6 grouped as "low acceptability" and scores 7 to 10 as "high acceptability".

    Measured: 14 weeks (three 4-week product use periods with 1-week washout periods between them)

  2. Adherence to Placebo Products

    Percentage of participants who used each study product as instructed

    Measured: 14 weeks (three 4-week product use periods with 1-week washout periods between them)

  3. Number of Grade 2+ Related Adverse Events

    Number of all Grade 2 or higher related adverse events (AE) reported in the study as defined by the DAIDS AE Grading Table

    Measured: 14 weeks (three 4-week product use periods with 1-week washout periods between them)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Sep 2018
  2. Study start26 Apr 2019
  3. Primary completion27 Jul 2020
  4. Study completion27 Jul 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Crossover
Masking
None (open label)
Enrolment
217 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03671239
Sponsor's protocol ID
MTN-035
Other IDs
UM1AI068633, UM1AI068615, UM1AI106707, 38459
Status last verified
Jan 2023
First submitted
23 Aug 2018
Last updated
20 Jan 2023
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Bauermeister J, Tingler R, Liu A, Chariyalertsak S, Hoesley C, Gonzales P, et al. Acceptability and choice for three placebo products used with receptive anal sex. Conference on Retroviruses and Opportunistic Infections (CROI), Mar 6-10, 2021; Abstract # 716

  • Bauermeister J, Lin W, Tingler R, Liu A, Chariyalertsak S, Hoesley C, Gonzales P, Ho K, Kayange N, Phillips TP, Johnson S, Brown E, Zemanek J, Jacobson CE, Doncel GF, Piper J; MTN-035 Protocol Team for the Microbicide Trials Network. A conjoint experiment of three placebo rectal products used with receptive anal sex: results from MTN-035. J Int AIDS Soc. 2024 Mar;27(3):e26219. doi: 10.1002/jia2.26219.

    PubMed 38494656
  • Choi SK, Bauermeister J, Tingler RC, Johnson S, Macagna N, Ho K, Hoesley C, Liu A, Kayange N, Palanee-Phillips T, Chariyalertsak S, Gonzales P, Piper JM; MTN-035 Protocol Team. A latent trajectory analysis of young sexual and gender minorities' adherence to three rectal microbicide placebo formulations (MTN-035; a randomized crossover trial). BMC Public Health. 2023 Dec 8;23(1):2464. doi: 10.1186/s12889-023-17368-y.

    PubMed 38066471

Questions about this trial

What is this clinical trial studying?

A study of HIV Prevention, run by Microbicide Trials Network at 7 sites in 5 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 14 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 20 Jan 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in United States, Malawi, Peru, South Africa, Thailand. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 20 Jan 2023). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Acceptability of Future Product Use (time frame: 14 weeks (three 4-week product use periods with 1-week washout periods between them)). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03671239, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Jan 2023.

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