Overview

Bacterial Vaginosis Home Screening to Prevent STDs

Status:
Completed
Trial end date:
2014-12-31
Target enrollment:
0
Participant gender:
Female
Summary
The purpose of this study is to determine whether regular screening (every 2 months) and treatment for bacterial vaginosis (BV [infection of the vagina]) will reduce the number of incidences of chlamydia and gonorrhea (sexually transmitted diseases) over the course of a year. Chlamydial and gonococcal infections will be determined by vaginal swab testing at 4, 8, and 12 months after enrollment. Subjects will include 1500 women aged 15-25 years who have clinical evidence of BV, with no symptoms. Subjects will be randomly assigned to 1 of 2 possible study groups: the intervention group (treatment of BV) or the control group (no BV treatment). Every 2 months, subjects will complete a home self-testing kit for screening of BV using a swab. If BV is detected by self-test, the subjects in the interventional group will receive a 7 day course of the antibiotic metronidazole. Participants will be involved in study related procedures for up to 12 months.
Phase:
Phase 3
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
National Institute of Allergy and Infectious Diseases (NIAID)
Treatments:
Metronidazole
Criteria
Inclusion Criteria:

-Subject provides written informed consent, or if subject is under age 18, parent signs
informed consent and subject signs assent. -Female age 15-25 years (age at last birthday).
-Vaginal intercourse within the past 3 months. -Asymptomatic bacterial vaginosis (BV) a.
Vaginal pH > 4.5 b. Clue cells on wet prep microscopy, >20 percent c. Woman denies unusual
or abnormal vaginal odor and discharge. -Two or more risk factors for sexually transmitted
diseases (STDs): a. Age less than or equal to 20 b. African-American race c. Hispanic
ethnicity d. Regular douching (at least one time per month) e. Two or more sex partners
(past 12 months) f. Current or past STD (past 12 months). -Be able to understand study
procedures . -Be able to comply with the study procedures for the entire length of the
study.

Exclusion Criteria:

-Self-reported pregnancy, or no menstrual period in past 4 weeks and positive urine
pregnancy test Note: We will exclude women who are pregnant at the time of enrollment
because some guidelines recommend screening and treatment for bacterial vaginosis (BV) in
high-risk women during pregnancy. -Regular use of antibiotics: use at least once daily for
2 of the past six months ( e.g., for acne). Note: Women taking antibiotics on a regular
basis will be excluded because antibiotic use could affect both BV and chlamydia/gonorrhea
infections. -Self-reported currently married/partnered and living with husband/partner of
over 1 year. This does not include married women who are separated. Note: We will exclude
women who are married and who are in established long term relationships because our goal
is to enroll a sample of women at high-risk for sexually transmitted diseases (STDs).
Although these women are at risk for STDs, they are at lower risk overall than women who
are single, separated, or divorced. -Homeless Note: We will exclude women who are homeless
because they are likely to be difficult to track. -Excessive alcohol use (consumes more
than 14 alcoholic drinks per week, or is not willing to abstain from alcohol for one week
in order to take medication). Note: We will exclude persons who do not think they could
avoid drinking alcohol for one week to take an antibiotic (because metronidazole plus
alcohol can lead to nausea and vomiting). -Allergy to metronidazole. -Current or history of
seizure disorder. -Current or history of any kind of neuropathy. -Use of warfarin sodium
(Coumadin ®). -Use of cimetidine (Tagamet ®). -Known liver disease. Note: we will exclude
women with current seizure disorders, women taking warfarin (Coumadin), women taking
cimetidine, and women with known liver disease; as such women may be at greater risk of
adverse consequences from taking metronidazole. -History of hysterectomy. Note: we will
exclude women who have had a hysterectomy because most chlamydial and gonococcal infections
target the cervix. -Trichomonas vaginalis detected via wet mount during eligibility
assessment. Note: we will also exclude women with a trichomonas infection identified during
eligibility assessment through wet mount evaluation because we will treat them with a
single dose of metronidazole. Such treatment would affect BV among women in the study.
Women treated with metronidazole during eligibility assessment will have to wait for one
month post treatment to become eligible for the study. -Unable to swallow pills. -Has an
active uncontrolled medical condition, such as cancer, or per the judgment of the principal
investigator should not participate in the study. -Women who are in the menstrual phase of
the menstrual cycle. -Current participation in another research study of an investigational
drug. -For women younger than age 18 years (19 in Alabama), a parent or guardian they live
with is unaware that she is sexually active.