STI Testing to Enhance PrEP Use in Pregnancy

NCT ID: NCT06919614

Last Updated: 2025-07-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

600 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-06-18

Study Completion Date

2029-08-31

Brief Summary

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The investigators are conducting a study in Botswana to see if offering STI testing along with expanded HIV prevention options (PrEP) helps more pregnant women start and continue using PrEP during and after pregnancy. Pregnant women (n=600) seeking antenatal care in Botswana will be enrolled and randomly assigned to receive the standard of care (standard STI assessment with no STI testing) versus STI testing for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis during pregnancy and postpartum. The investigators' hypothesis is that providing STI testing alongside PrEP offer will encourage more women to start and continue using PrEP.

Detailed Description

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The investigators are conducting a 2-arm 1:1 randomized trial to compare PrEP delivery with co-offer of STI testing for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis (using Xpert CT/NG and TV assays) vs. standard-of-care (SOC, syndromic management) among pregnant women without HIV (n=600) in Botswana. Antenatal care clients will be offered PrEP (self-select oral pills or DPV-VR).

Participants will be followed up to 9 months postpartum. Women will be able to switch PrEP methods and start, stop, or restart PrEP at any time.

Primary outcomes are the proportion of clients who initiate PrEP, persist with use at 9 months postpartum, and adhere (quantified by hair drug levels). Secondary outcomes are PrEP choice (pills vs. DPV-VR), STI rates, and birth outcomes by randomization arm. Exploratory outcomes are HIV incidence, quality of care, adherence cofactors, and antimicrobial resistance.

Conditions

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PrEP Adherence Sexually Transmitted Infections (STIs) Pregnancy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Intervention arm

Participants randomized to the intervention arm will be offered Xpert® CT/NG and TV testing and treatment (in addition to syndromic STI assessment) at three time points (enrolment, at the 32 weeks' gestation visit and 9-month post-delivery visit) or two time points for participants enrolled in their third trimester. If a client accepts Xpert® testing, they will be instructed by the study clinician/research assistant on how to self-collect a vaginal swab.

Group Type EXPERIMENTAL

Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis testing

Intervention Type DIAGNOSTIC_TEST

Xpert® CT/NG and TV testing

Standard-of-care arm

Participants in the standard-of-care arm will receive syndromic STI assessment per Botswana national guidelines. They will be offered Xpert® CT/NG and TV testing at the 9-month post-delivery visit only.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis testing

Xpert® CT/NG and TV testing

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Pregnant and seeking antenatal care
* Self-identifying as a cis-gender woman
* Living without HIV
* Not currently using PrEP
* Planning to remain in the city/town of enrolment until 9 months post-delivery.
* Planning to receive antenatal and postnatal care in the city/town of enrolment.
* Willing and able to provide informed consent

Exclusion Criteria

* Male gender
* Not pregnant
* Living with HIV
* Currently using PrEP
* Not planning to remain in the city/town of enrolment until 9 months post-delivery
* Not planning to receive antenatal and postnatal care in the city/town to enrolment
* Not able or willing to provide informed consent for participation
Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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University of Washington

OTHER

Sponsor Role collaborator

University of Botswana

OTHER

Sponsor Role collaborator

Botswana Harvard AIDS Institute Partnership

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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DHMT Clinics

Gaborone, , Botswana

Site Status RECRUITING

Countries

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Botswana

Central Contacts

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Chelsea Morroni, MBChB, DFSRH, MPH, PhD

Role: CONTACT

‭+267 316 6657‬

Facility Contacts

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District Health Management Team, Greater Gaborone

Role: primary

+2673905792

Other Identifiers

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BHP180

Identifier Type: -

Identifier Source: org_study_id

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