Developing Rectal USPE Measures for Suppositories (Project DRUM-S) (DRUM-S)

Evaluating User Perceptions and Experiences of Dual Compartment Microbicide Formulations. Project 5.3: Developing Rectal USPE Measures for Suppositories (Project DRUM-S)

The purpose of this study is to (a) adapt existing user sensory perception and experience (USPE) items/instruments generated for rectal gel/cream formulations to include USPEs specific to suppository forms for rectal and vaginal use; (b) for both male and female cohorts: to capture the experience of suppository use in the context of receptive anal intercourse (RAI); and (c) for female cohort only: to capture the experience of suppository use in the context of vaginal-penile intercourse (VI), and to compare USPEs of suppository use in the context of RAI to USPEs of suppository use in the context of vaginal-penile intercourse.

Study Overview

• Status: Completed
• Conditions: Microbicide Delivery System Perceptibility and Acceptability
• Intervention / Treatment: Other: Gel; Other: Suppository 1; Other: Suppository 2

Detailed Description

HIV prevention is a global public health priority. Providing efficacious prevention methods that have the greatest likelihood of use will have a profound impact on the public's health. Critical to their use is "acceptability." However, current conceptualizations of adherence and acceptability fail to fully articulate and account for patterns of use and non-use. Formulation properties are critically important to both drug delivery and the user experience. Microbicide developers thus have the opportunity to directly control a formulation's impact on acceptability and adherence to product use, as well as biological product performance. Microbicide products can and should be developed such that they achieve performance standards for both these behavioral (user experience) and biological (efficacy) functions. By incorporating the user experience early on in the product development process, developers will have the greatest chance of providing at-risk individuals with the best prevention methods science can provide. Developing prevention products that can be used in the vagina and/or the rectum and that optimize the user experience in both compartments increases the likelihood that these products will be used consistently and correctly. The impact on global public health has the potential to be far-reaching, decreasing HIV and sexually transmitted infections (STI) incidence and prevalence in both women and men.

Methodology and Data Collection: This is a formative mixed methods design in which volunteers (N~20-30; ~10-15 males; ~10-15 females) will first be prescreened for basic study eligibility using a brief questionnaire. Those who are interested in the study and are eligible based on their responses to the prescreen will then complete a STI/HIV screening and pregnancy test (for females).

During the course of the study, participants will evaluate 3 products: 2 distinct suppository formulations and 1 gel formulation that represent a range of rheological and other biophysical properties of potential microbicides being designed for rectal/dual compartment use. Participants will evaluate the experience of suppository use (as compared to gel use) in the context of receptive anal intercourse (RAI) among males and females, and in the context of vaginal intercourse (VI) (females). Each participant will be randomly assigned to the order in which they will evaluate the 3 products. After a sexual encounter that includes RAI/VI and study product use, participants will be required to complete a web survey about their experience with the study product.

• Study Type: Interventional
• Enrollment (Actual): 32
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Rhode Island
    • Providence, Rhode Island, United States, 02903
      • The Miriam Hospital Centers for Behavioral and Preventive Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Study Population

Individuals residing in the greater Providence, RI and southeastern, MA metropolitan areas

Description

All participants must meet all of the inclusion criteria to participate in this study.

Inclusion Criteria:

All participants must meet all of the inclusion criteria to participate in this study.

• Eligible male participants must be 18 years of age or older
• Eligible female participants must be 18-45 years of age

Inclusion criteria include men and women who:

• Report receptive anal intercourse (RAI) at least twice in the past 6 months
• Are willing to use each study product in conjunction with RAI on at least one occasion in each data collection period (resulting in a minimum of 3 RAI events during each product evaluation period; on average every 2 weeks, all 3 products across an average of 6 -12 weeks)
• Are willing and able to respond to study data collection systems via phone and internet, attend all study visits, and participate in in-depth qualitative interviews

Additional Inclusion Criteria for Female Volunteers:

• Report vaginal-penile intercourse (VI) at least twice in the past 6 months
• Willing to use each study suppository formulation in conjunction with VI on at least one occasion in each data collection period (resulting in a minimum of 2 vaginal intercourse events during the course of the study)
• Report consistent use of an effective birth control method: e.g., hormonal contraceptive, IUD, bilateral tubal ligation, Essure® or any non-incisional permanent birth control procedure, hysterectomy (partial or total, with/without oophorectomy), partner's vasectomy/salpingectomy

Exclusion Criteria:

• Have a sensitivity or allergy to vaginal, anal, or rectal products
• Have a sensitivity or allergy to any of the ingredients contained in the study products
• Have a sensitivity or allergy to sesame seeds
• Are HIV-positive at baseline, or have a known HIV-positive sexual partner
• Have an active rectal or reproductive tract infection requiring treatment per current CDC guidelines or have other condition that, in the opinion of the investigator/study clinician, make the patient unsuitable for the study or unable to comply with study requirements (Note: HSV seropositivity without active genital lesions is not an exclusion criteria)
• Urinary tract infection (UTI)
• Have current inflammatory bowel disease (IBD) or history of active IBD within last 3 months
• Have any other significant colorectal symptom(s) as determined by medical history, participant self-report, or physical exam (including but not limited to presence of any unresolved injury, infectious or inflammatory condition of the local mucosa, presence of symptomatic external hemorrhoids, and presence of any painful anorectal conditions that would be tender to manipulation)
• Have any other clinical condition or prior therapy that, in the opinion of the investigator/study clinician, would make the patient unsuitable for the study or unable to comply with the study requirements (including, as determined by medical history, participant self-report, or physical exam: heart disease, high blood pressure, thyroid disease, diabetes, difficulty urinating due to prostate gland enlargement; taking psychotropic medications such as monoamine inhibitors, tricyclic antidepressants, SSRIs)
• Are unwilling to refrain from use of nonoxynol-9 (N9) for the duration of the study
• Are currently enrolled in other rectal or vaginal product studies
• Are unable or unwilling to communicate in English, or
• Are unable or unwilling to give written informed consent

Additional Exclusion Criteria for Female Volunteers:

• Are pregnant or breastfeeding. Pregnancy testing will be conducted at Visits 1-4 (screening and prior to any product use period)
• Have completed menopause (i.e., at least 12 months without menstrual periods)
• Are currently attempting to get pregnant or have an intention to get pregnant during their participation in the study
• Are unwilling to refrain from use of any vaginal product (inclusive of douching; exclusive of tampons during menses) other than study products
• Have clinically significant abnormal pelvic findings and/or findings requiring therapy as a function of clinical exam at Visit 1
• Report being within 30 days of their last pregnancy outcome or gynecologic surgical procedure

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Formulations; Gel, Suppository 1, Suppository 2	Other: Gel; 4 mL; Other Names: Orange; Other: Suppository 1; Other Names: Green; Other: Suppository 2; Other Names: Yellow

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
User Perception Scale Scores	USPE Sum of averaged item means/# items (min:max 1:5); 1=Do not agree at all;2=Agree a little;3=Agree somewhat;4=Agree a lot;5=Agree completely Products:Gel/Orange, Suppository 1/Green, Suppository 2/Yellow. Initial Penetration:Smoothness/lubricity; Initial Lubrication:Coating/lubricating; Spreading Behavior:Ease of stroke, product spread; Product Awareness:Feel during sex (movement, felt betw vaginal/rectal wall-penis); Perceived Wetness:Covering entire vagina/rectum; Stimulating:enhanced pleasure; Messiness:Perceptions of messiness; Leakage:Sensations of leaking during/after sex; Pre-coital Leakage:Product felt/leakage on body or clothes before sex; Naturalness:Sensation of naturalness; leakage looked like vag fluid/cum; Lubricity:Wetness before sex; slipperiness/lubricity during sex; Effortful:Effort needed at penetration; effort difficulty/dryness; Pleasure:Partner's stimulation; Noticeable:messiness, thickness. Higher scores=greater agreement re: product characteristics	Web-based survey (same survey; 3 times; one for each formulation) over an average of 6-12 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
User Perception Scale Scores	Quantitative User Sensory Perception and Experience Scale scores across 3 formulations: ranges, means, standard deviations.	Web-based survey (same survey; 3 times; one for each formulation) over an average of 6-12 weeks

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Daily Product Use and Sexual Behavior Survey	brief (<3 minutes) automated phone survey capturing sexual behavior (esp. RAI and VI) and study product use in conjunction with RAI/VI, as well as condom use (if applicable). Also allows initial reporting of concerns, side effects, and adverse events, which trigger an alert to study clinician for triage.	daily over an average of 6-12 weeks

Collaborators and Investigators

• Sponsor: The Miriam Hospital
• Collaborators: National Institute of Allergy and Infectious Diseases (NIAID); ImQuest Pharmaceuticals, Inc.
• Investigators: Principal Investigator: Robert Buckheit, PhD, ImQuest Pharmaceuticals, Inc.; Principal Investigator: Kate Guthrie, PhD, The Miriam Hospital: Centers for Behavioral & Preventive Medicine

Publications and helpful links

General Publications

• Guthrie KM, Rosen RK, Guillen M, Ramirez JJ, Vargas SE, Fava JL, Ham AS, Katz DF, Cu-Uvin S, Tumilty S, Smith KA, Buckheit KW, Buckheit RW , Jr. Designing Dual Compartment HIV Prevention Products: Women's Sensory Perceptions and Experiences of Suppositories for Rectal and Vaginal Use. AIDS Res Hum Retroviruses. 2022 Jul;38(7):601-610. doi: 10.1089/AID.2021.0038. Epub 2021 Oct 18.

Study record dates

Study Major Dates

• Study Start (Actual): August 11, 2016
• Primary Completion (Actual): April 13, 2017
• Study Completion (Actual): April 1, 2022

Study Registration Dates

• First Submitted: April 12, 2016
• First Submitted That Met QC Criteria: April 15, 2016
• First Posted (Estimated): April 20, 2016

Study Record Updates

• Last Update Posted (Actual): February 10, 2026
• Last Update Submitted That Met QC Criteria: February 9, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: HIV; STI; Primary Prevention; Drug Delivery Systems; User Experience; Topical Microbicides
• Additional Relevant MeSH Terms: Urogenital Diseases; Genital Diseases; Pathologic Processes; Disease Attributes; Infections; Communicable Diseases; Pathological Conditions, Signs and Symptoms; Sexually Transmitted Diseases; Pharmaceutical Preparations; Dosage Forms; Complex Mixtures; Colloids; Gels; Green Or
• Other Study ID Numbers: 30048; U19AI101961 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: as per individual agreement, provided data safety/confidentiality agreements are met