HIV Clinical Trial
Official title:
A Multi Center, Open-Label, Randomised Clinical Trial Comparing HIV Incidence and Contraceptive Benefits in Women Using Depot Medroxyprogesterone Acetate (DMPA), Levonorgestrel (LNG) Implant, and Copper Intrauterine Devices (IUDs)
The ECHO Study is an open-label randomized clinical trial that will compare three highly effective, reversible methods of contraception (including a non-hormonal method) to evaluate whether there is a link between use of any of these methods and increased risk of acquiring HIV infection. A randomized clinical trial among about 7,800 women in four countries, ECHO will deliver evidence to support and guide individual, policy and programmatic decisions on contraception for women at risk of acquiring HIV infection.
Approximately 7800 sexually active, HIV-negative women, 16-35 years old, seeking effective
contraception, willing to be randomized to any of the study arms, and not desiring pregnancy
for the duration of study participation will be randomly allocated to one of three study arms
in a 1:1:1 ratio: depot medroxyprogesterone acetate (DMPA), levonorgestrel (LNG) implant,
copper intrauterine device (IUD).
Enrollment will require an estimated 18 months and the total duration of the clinical portion
of the study is estimated to be 36 months.
The primary objective is to compare the risks of HIV acquisition between women randomized to
DMPA, levonorgestrel (LNG) implant, and copper IUDs. Secondary objectives are to compare: 1)
pregnancy rates among women randomized to DMPA, LNG implant, and copper IUDs, 2) rates of
serious adverse events among women randomized to DMPA, LNG implant, and copper IUDs, 3) rates
of adverse events that lead to method discontinuation among women randomized to DMPA, LNG
implant, and copper IUDs, and 4) contraceptive method continuation rates among women
randomized to DMPA, LNG implant, and copper IUDs. Tertiary objectives are to evaluate: 1)
whether age modifies the relationship between the three contraceptive methods and HIV
acquisition, 2) whether HSV-2 status modifies the relationship between the three
contraceptive methods and HIV acquisition, and 3) early HIV disease progression among
sero-converters randomized to DMPA, LNG implant, and copper IUDs. Ancillary studies will
assess biological mechanisms at the interface of contraceptives and markers of HIV risk.
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