The Women TAF-FTC Benchmark Study

NCT ID: NCT05140954

Last Updated: 2025-10-27

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2/PHASE3
• Total Enrollment: 54 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-03-28
• Study Completion Date: 2023-12-19

Brief Summary

The study seeks to assess the safety of and define blood and tissue benchmark concentrations of tenofovir diphosphate (TFV-DP) and emtricitabine triphosphate (FTC-TP) in cisgender women using directly observed oral pre-exposure prophylaxis (PrEP) therapy with tenofovir alafenamide-emtricitabine (TAF-FTC). Cisgender women will be randomly assigned to receive varying frequencies of weekly PrEP doses and followed for up to 18 weeks.These data will help accurate interpretation of efficacy results obtained in HIV prevention trials and programs in cisgender women.

Detailed Description

This is an open-label, randomized, three-arm, directly observed therapy (DOT), pharmacokinetics study. HIV-uninfected non-pregnant cisgender women at low risk for HIV acquisition will be randomly assigned to 1 of 3 dosing frequencies of DOT with tenofovir alafenamide-emtricitabine (TAF-FTC) oral PrEP, to help differentiate poor and moderate from perfect adherence. The primary objectives of the study are:

1. To describe the safety of TAF-FTC-based PrEP in HIV-uninfected cisgender women.

2. To define expected blood concentrations and dose-proportionality specific to cisgender women for tenofovir-diphosphate (TFV-DP) in dried blood spots (DBS) and peripheral blood mononuclear cells (PBMCs) using directly observed therapy of TAF-FTC at 2, 4, and 7 doses per week, representing poor, moderate, and perfect adherence, respectively.

3. To establish a model to predict adherence rate to TAF-FTC by level of TFV-DP in DBS for cisgender women. HIV-uninfected non-pregnant cisgender women will be randomly assigned to 1 of 3 dosing frequencies of directly observed therapy of TAF-FTC oral PrEP: 2, 4, or 7 doses/week to differentiate poor and moderate from perfect adherence.

The study will be the first to define TAF-FTC-based PrEP adherence-blood concentration thresholds for African cisgender women, a priority population for HIV prevention. The findings will guide accurate interpretation of safety, adherence, and efficacy of planned or ongoing HIV prevention trials in African women.

Conditions

HIV Infections

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: NONE

Study Groups

Perfect Adherence

Cisgender women will receive a single tablet of coformulated 25 mg TAF/ 200mg FTC once daily (7 doses per week).

Group Type: EXPERIMENTAL

co-formulated 25mg TAF/ 200mg FTC

Intervention Type: DRUG

Participants will be randomized into 1 of 3 groups to receive a controlled number of doses of a single tablet of co-formulated 25 mg TAF/ 200mg FTC

Moderate Adherence

Cisgender women will receive a single tablet of coformulated 25 mg TAF/ 200mg FTC 4 times per week

Group Type: EXPERIMENTAL

co-formulated 25mg TAF/ 200mg FTC

Intervention Type: DRUG

Participants will be randomized into 1 of 3 groups to receive a controlled number of doses of a single tablet of co-formulated 25 mg TAF/ 200mg FTC

Poor Adherence

Cisgender women will receive a single tablet of coformulated 25 mg TAF/ 200mg FTC twice per week

Group Type: EXPERIMENTAL

co-formulated 25mg TAF/ 200mg FTC

Intervention Type: DRUG

Participants will be randomized into 1 of 3 groups to receive a controlled number of doses of a single tablet of co-formulated 25 mg TAF/ 200mg FTC

Interventions

co-formulated 25mg TAF/ 200mg FTC

Participants will be randomized into 1 of 3 groups to receive a controlled number of doses of a single tablet of co-formulated 25 mg TAF/ 200mg FTC

Intervention Type: DRUG

Other Intervention Names

Descovy

Eligibility Criteria

Inclusion Criteria

• Age ≥18 and ≤30 years old
• Willing to undergo urine pregnancy tests
• Has understood the information provided and has provided written informed consent before any study-related procedures are performed.
• HIV uninfected based on negative HIV rapid tests, according to Kenyan national algorithm
• Normal renal function (estimated glomerular filtration rate >60 mL/min)
• Hepatitis B surface Ag negative
• No active clinically significant medical or psychiatric conditions that, in the opinion of the investigators, would interfere with study participation
• Lack of severe anemia (Hemoglobin >10 g/dL)
• Willing to use DOT and come to clinic frequently for DOT PrEP for at least 10 weeks
• Willing to have home visits for follow up
• Has access to an active smartphone to allow off-site observation of dosing if unable to come to the clinic or as determined by the study staff, the participant resides in close location to clinic to permit home visit if unable to come to the clinic. i.e., potential participants without a smartphone may be enrolled in the study if investigator determines that the participant resides within reasonable distance from the clinic that would permit home visit id the participant misses their visit.
• Intention to stay within the study site's catchment area for at least 10 weeks.
• Resides or works in catchment area with high speed internet coverage to permit video streaming
• Not pregnant or breast feeding
• Willing to use effective contraception during the study period.
• At low risk for HIV. In Kenya, national guidelines define substantial risk for HIV and recommend PrEP be an option for individuals reporting: partner of HIV-infected person not on ART or on ART for <6 months, >1 partner of unknown status, transactional sex, recent STI, recurrent PEP use, inconsistent condom use, or injection drug use. So, non-pregnant cisgender women reporting any of these factors will not be eligible for the study but will be linked for PrEP at clinic of choice including at Thika Site itself.
• Willing to be randomized to non-daily PrEP and come to clinic frequently for DOT PrEP
• Willingness and ability to be abstinent for at least 7 days after each vaginal biopsy visit.

Exclusion Criteria

• Inability to give informed consent
• Positive screening HIV+ as determined by standard rapid serologic assays or suspected acute HIV infection in the opinion of the clinician. (example signs and symptoms of acute HIV infection include combinations of fever, headache, fatigue, arthralgia, vomiting, myalgia, diarrhea, pharyngitis, rash, night sweats, and adenopathy cervical or inguinal)
• Positive HBV surface antigen test at screening
• Calculated creatinine clearance <60 ml/min.
• Any laboratory value or uncontrolled medical conditions that, in the opinion of the investigators, would interfere with the study conditions such as, heart disease and/or cancer.
• Prohibited concomitant medications are: investigational agents (within 30 days of enrollment), aminoglycosides, ganciclovir/valganciclovir, chronic high-dose acyclovir/valacyclovir (>800mg acyclovir or >500mg valacyclovir for >7 days), cyclosporine, amphotericin B, foscarnet, and cidofovir, and products with same or similar active ingredients as the study medications including TAF®, TRUVADA®, ATRIPLA®, COMPLERA®, EMTRIVA®, VIREAD®; or drugs containing lamivudine or adefovir, which are close analogs of FTC and tenofovir, respectively.
• Current or past use of PrEP (pre-exposure prophylaxis)
• Not willing to have home visits
• Pregnancy or plan to become pregnant in the next 6 months or unwillingness to use birth control
• Current breastfeeding
• High risk of HIV infection (for example: sexually active with an HIV infected partner; engages in condomless intercourse with HIV-infected partners or partner of unknown status during the study; females who exchange sex for money, shelter, or gifts; active injection drug use or during the last 12 months; newly diagnosed sexually transmitted infections in last 6 months.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 30 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: Yes

Sponsors

Kenya Medical Research Institute

OTHER

Sponsor Role: collaborator

University of Colorado, Denver

OTHER

Sponsor Role: collaborator

Gilead Sciences

INDUSTRY

Sponsor Role: collaborator

University of Washington

OTHER

Sponsor Role: lead

Responsible Party

Kenneth K Mugwanya

Assistant Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Kenneth K Mugwanya, MBChB, MS, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Washington

Peter L Anderson, PharmD

Role: PRINCIPAL_INVESTIGATOR

University of Colorado, Denver

Locations

Kenya Medical Research Institute - Partners in Health Research and Development

Thika, , Kenya

Countries

Kenya

Provided Documents

Document Type: Study Protocol, Statistical Analysis Plan, and Informed Consent Form

View Document

Other Identifiers

CO-US-412-6203

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

STUDY00014075

Identifier Type: -

Identifier Source: org_study_id