Duo: A Phase IIIb Individual-Level Randomized Controlled Trial of an Integrated Strategy
Duo: A Phase IIIb Individual-Level Randomized Controlled Trial of an Integrated Strategy of HIV PrEP and STI PEP for Young Men
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Michelle Robinson
- Phone Number: 919-321-3585
- Email: mrobinson@fhi360.org
Study Contact Backup
- Name: Kailazarid Gomez-Feliciano, MPM
- Phone Number: 919-321-3486
- Email: kgomez@fhi360.org
Study Locations
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Buenos Aires, Argentina, C1427CEA
- Fundacion Huesped CRS
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Contact:
- Maria Figueroa
- Phone Number: 1132 54-11-49817777
- Email: maria.figueroa@huesped.org.ar
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Rio de Janeiro
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Manguinhos, Rio de Janeiro, Brazil, 221045-900
- Instituto de Pesquisa Clinicaq Evandro Chagas CRS
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Lima, Peru, 32-15088
- San Miguel CRS
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Contact:
- Javier Valencia
- Phone Number: 51-1948081626
- Email: jvalencia@impactaperu.org
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California
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Los Angeles, California, United States, 90095
- UCLA Vine Street Clinic
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Contact:
- Jesse Clark, MD
- Phone Number: 323-461-3106
- Email: jlclark@mednet.ucla.edu
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New York
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The Bronx, New York, United States, 10451
- Bronx Prevention Research Center CRS
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Contact:
- Ellen Morrison
- Phone Number: 212-305-6328
- Email: eam6@cumc.columbia.edu
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Men ages 18 - 29 years
- Men who are in communities most affected by the HIV epidemic
- Willing and able to provide informed consent
- Reports having anal sex with men in the last 6 months
Have certain risk factors for HIV acquisition, defined as any of the following in the past 6 months:
- Any condomless anal sex with a man; not including within a monogamous relationship with an HIV-negative partner or an HIV-positive partner who is virally suppressed
- Reporting 2 or more male partners, regardless of condom use
- Reporting gonorrhea, chlamydia, or syphilis diagnosis
- Any stimulant use (e.g., cocaine, amphetamines)
- Not on PrEP within the past 3 months due to participant choice
- Interested in learning more about PrEP or starting PrEP
- No evidence of HIV infection at Screening and Enrollment, based on the HIV testing algorithm
- Owns an iOS or Android mobile phone and able to successfully download mobile apps and send and receive text messages
- Must not share the mobile phone used for their participation in the study
- Able to read and write
Exclusion Criteria:
- Participated in HPTN 113-01
- Currently participating in another interventional trial of PrEP agents, or prior enrollment in studies of long-acting PrEP, including HPTN 083
- Plans to move away from the study area within the next year
- Currently on doxycycline for STI PEP
- Has ever used CAB-LA or other long-acting PrEP agent
- Tetracycline allergy
- Prior diagnosis of HIV infection
- Reactive HIV rapid test at Screening or reactive HIV Ag/Ab rapid test at Enrollment, regardless of subsequent HIV test results
- Any other condition that, in the opinion of the Investigator of Record (IoR)/designee, would preclude informed consent, make study participation unsafe, complicate interpretation of study outcome data, or otherwise interfere with achieving the study objectives would make the patient unsuitable for the study or unable/unwilling to comply with the study requirements
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: 3P mHealth package
HIV PrEP, doxy-PEP, 3P mHealth package (3P: MyPrEP + PrEPmate + PrEPsmart tools) to assist with PrEP uptake and adherence decision making, standard-of-care PrEP adherence counseling from qualified study staff, handout about the different PrEP options available at the site
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Choice of F/TDF, F/TAF, or CAB-LA for HIV prevention
Doxycycline as doxy-PEP for STI prevention
Suite of mHealth tools (MyPrEP, PrEPmate, PrEPsmart) to assist with HIV PrEP uptake and adherence decision making
Handout about HIV PrEP options available at the site
Standard-of-care HIV PrEP counseling from qualified study staff
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Active Comparator: Standard-of-care services
HIV PrEP, doxy-PEP, standard-of-care PrEP adherence counseling from qualified study staff, handout about the different PrEP options available at the site
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Choice of F/TDF, F/TAF, or CAB-LA for HIV prevention
Doxycycline as doxy-PEP for STI prevention
Handout about HIV PrEP options available at the site
Standard-of-care HIV PrEP counseling from qualified study staff
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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To determine the efficacy of the 3P mHealth package on PrEP uptake among participants
Time Frame: 52 weeks
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PrEP uptake is defined as the proportion of enrolled participants who elect to initiate PrEP (with a documented PrEP dispensation by the site) at any time during the 52 weeks of follow-up.
Participants who did not initiate PrEP before loss to follow-up will be classified as non-initiators.
PrEP uptake will be assessed at Week 52 for each study arm with 95% confidence limits computed using the binomial distribution.
A logistic regression model will be used to compare PrEP uptake between the study arms.
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52 weeks
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To determine the efficacy of the 3P mHealth package on PrEP adherence among participants
Time Frame: Weeks 20, 36, and 52
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PrEP adherence is assessed at Weeks 20, 36 and 52 through biomedical testing for oral PrEP regimens and documentation of CAB-LA injection for CAB-LA. Adherence measures are described in Section 8.7. Participants on oral PrEP missing an assessment visit and with no PrEP dispensed at their most recent visit will be considered non-adherent. Also, participants who have not yet initiated PrEP at a visit will be considered non-adherent at that visit. The average PrEP adherence at a visit will be computed as the proportion of participants who are determined to be adherent at that visit by study arm. The associated 95% confidence limits will be computed using the binomial distribution. Generalized estimating equations (GEE) with a logit link function will be used to examine differences in adherence proportions between the 3P and Control arms at Weeks 20, 36 and 52, while accounting for potential correlation between PrEP adherence measures over time for each participant. |
Weeks 20, 36, and 52
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To assess doxycycline PEP uptake and associated factors
Time Frame: Week 52
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doxy-PEP uptake is defined as the proportion of participants dispensed doxy-PEP during the 52 weeks of study follow-up period.
doxy-PEP uptake will be computed with 95% confidence limits at Week 52.
Multivariable logistic regression models will be used to assess association between doxy-PEP uptake and factors including study group, demographic and behavioral characteristics.
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Week 52
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To assess doxycycline PEP use and associated factors
Time Frame: Weeks 20, 36, and 52
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doxy-PEP use will be assessed at Weeks 20, 36 and 52.
Doxy-PEP use at an assessment visit will be computed as the proportion of participants reporting use following sex acts, reported at that visit.
The corresponding 95% confidence limits will be computed based on the binomial distribution.
Multivariable GEE models will be used to investigate possible associations between doxy-PEP use and factors including study group, demographic and behavioral characteristics.
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Weeks 20, 36, and 52
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To assess doxycycline PEP acceptability and associated factors
Time Frame: Week 52
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Descriptive statistics will be used to summarize doxy-PEP acceptability.
Multivariable generalized linear models (with a link function that is appropriate to the scale of the measure for doxy-PEP acceptability) will be used to investigate associations between doxy-PEP acceptability and factors including study group, sociodemographic, and behavioral characteristics.
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Week 52
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To assess the incidence of HIV infections among participants choosing to use CAB-LA
Time Frame: Week 52
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Uptake of CAB-LA is defined as the proportion of participants choosing to initiate CAB-LA with a documented receipt of a CAB-LA injection during the study follow-up period. CAB-LA uptake will be computed with 95% confidence interval. Incidence of HIV infection between the date of CAB-LA initiation and the date of switch to oral PrEP (for participants switching from CAB-LA to oral PrEP) or end of follow-up (for participants staying on CAB-LA from initiation through the end of the follow-up period) will be computed with 95% confidence interval among participants choosing to use CAB-LA. |
Week 52
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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To determine the acceptability and use of the 3P mHealth package in the intervention arm by site
Time Frame: Week 52
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Descriptive statistics will be used to summarize the acceptability and use of the 3P mHealth package in the intervention arm by site.
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Week 52
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To compare the frequency, directionality, and reasons for PrEP regimen choice and switching, between arms
Time Frame: Week 52
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Descriptive statistics will be used to summarize the frequency, directionality, and reasons for PrEP regimen choice and switching by arm.
Generalized linear models will be used to assess differences in these descriptive summaries between the study arms.
Reasons for PrEP regimen choice and switching obtained from qualitative interview data will be listed by arm.
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Week 52
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To evaluate demographic, behavioral, and attitudinal factors associated with choice of PrEP regimen
Time Frame: Week 52
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Multivariable logistic regression models will be used to separately assess associations between each PrEP regimen choice and demographic, behavioral, and attitudinal factors.
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Week 52
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To determine the efficacy of the 3P mHealth package on prevention-effective adherence
Time Frame: Weeks 20, 36, and 52
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Weeks 20, 36, and 52
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Chair: Susan Buchbinder, MD, San Francisco Department of Public Health and University of California San Francisco
- Study Chair: Jorge Gallardo-Cartagena, MD, Centro de Investigaciones Tecnológicas Biomédicas y Medioambientales
- Study Chair: Thiago Torres, MD, Instituto Nacional de Infectología Evandro Chagas
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
- Post-Exposure Prophylaxis (PEP)
- Human Immunodeficiency Virus (HIV)
- Pre-Exposure Prophylaxis (PrEP)
- Integrated Strategy
- Hepatitis B (HBV)
- Sexually Transmitted Infection (STI)
- Young Men
- Doxycycline for STI Post-Exposure Prophylaxis (Doxy-PEP)
- Chlamydia Trachomatis (CT)
- Neisseria Gonorrhea (NG)
- Mobile Health Tools (mHealth)
- MyPrEP + PrEPmate + PrEPsmart Tools (3P)
Additional Relevant MeSH Terms
- Blood-Borne Infections
- Urogenital Diseases
- Genital Diseases
- Pathologic Processes
- Disease Attributes
- Immune System Diseases
- Infections
- RNA Virus Infections
- Virus Diseases
- Digestive System Diseases
- Liver Diseases
- Hepatitis, Viral, Human
- Communicable Diseases
- Sexually Transmitted Diseases, Viral
- Lentivirus Infections
- Retroviridae Infections
- Immunologic Deficiency Syndromes
- DNA Virus Infections
- Slow Virus Diseases
- Hepadnaviridae Infections
- Hepatitis
- Pathological Conditions, Signs and Symptoms
- HIV Infections
- Acquired Immunodeficiency Syndrome
- Sexually Transmitted Diseases
- Hepatitis B
Other Study ID Numbers
Other Study ID Numbers
- HPTN 113
- UM1AI068619 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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