- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02167386
PrEPared and Strong: Clinic-Based PrEP for Black MSM (P&S)
PrEP for Black MSM: Community-Based Ethnography and Clinic-Based Treatment
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
STUDY OBJECTIVES AND DESIGN This randomized clinical trial will enroll HIV-uninfected Black MSM and transgender females (TGF) and randomly assign them to receive enhanced versus standard PrEP adherence packages. Study participants will receive PrEP-related clinical care at Harlem United, a community-based healthcare provider in New York City's Central Harlem.
Primary Objective Compare the effectiveness of enhanced versus standard packages for increasing adherence to PrEP in a community-based primary care clinic
Secondary Objectives
Compare the enhanced and standard PrEP adherence packages on:
- sexual risk behaviors
- retention in care
- PrEP knowledge
- seroconversions
- Examine the safety of PrEP among participants as measured by the type and frequency of adverse events
- Describe acceptability of daily PrEP among Black MSM and TGF generally and among those who have agreed to take PrEP
Study Design This is an open-label, randomized clinical trial that aims to assess the effectiveness of an enhanced PrEP adherence package compared to a standard PrEP adherence package on PrEP adherence. PrEP uptake, acceptability, safety, retention in care, and feasibility will also be measured. Participants will be prescribed once daily oral co-formulated emtricitabine/tenofovir disoproxil fumarate (Truvada) by physicians at Harlem United, a community-based primary-care clinic located in Harlem, New York City. 200 participants will be recruited through: Harlem United client services; studies being conducted at the Harlem Prevention Center; the study's ethnographic component; and targeted direct recruitment strategies. Each participant will receive PrEP for one year. In addition to PrEP, all participants will receive comprehensive HIV prevention services with access to condoms, risk reduction counseling, and STI screening and treatment. Participants will have follow up clinical visits at 12 week intervals to be evaluated for side effects, renal toxicity, adherence, risk behavior, and HIV seroconversion.
Additionally, the study will assess: 1) correlates of PrEP knowledge, uptake, safety, retention in care, and acceptability among Black MSM and TGF individuals who are determined to be eligible for PrEP based on self-reported sexual risk behavior and history of sexually transmitted infections (STIs); and 2) patterns and correlates of adherence among participants in the study. The project will also assess other aspects of PrEP feasibility including risk compensation and side effects.
The first eligible 50 individuals who are agree to be in the study but decline to take PrEP will be asked to answer a brief set of questions about the reasons for their decision.
STUDY POPULATION
Description of Study Site The study will be implemented in Harlem, New York by the Harlem Prevention Center (HPC), Mailman School of Public Health, Columbia University. HPC is located on 125th Street in Central Harlem and is the home for various HIV and tuberculosis (TB) studies, including HIV prevention studies. Informed consent and research interviews will be conducted and study records stored at HPC.
Harlem United (HU), a community-based organization offering health and social services in Central Harlem, will serve as the locus of many study activities. HU has the capacity to comply with the protocol, project-specific procedures, and all applicable regulations. HU locations include 1) HOME (Helping Our Members Evolve), a drop-in center for younger MSM and TGF clients, 2) the Prevention Center which provides non-clinical HIV and non-HIV services to clients of all ages and genders, and 3) the Willis P. Green Jr Clinic providing HIV and non-HIV medical services. All sites have reception areas with waiting areas, counseling rooms, private rooms for HIV testing, and data management areas. Additionally, the clinic has physical examination rooms, medication storage areas, and access to laboratory facilities.
Description of Study Population The study population is Black MSM and TGF, who are at-risk for HIV infection. MSM and TGF at-risk for HIV infection are defined as men or male-to-female transgendered individuals who report indicators of HIV risk. We expect that approximately 95% of participants will be MSM due to their larger population size in the Harlem community.
STUDY PROCEDURES Individuals who meet criteria for the study will receive a referral for medical assessment. Individuals who are medically eligible to take PrEP and who agree to initiate PrEP will provide Informed Consent. They will then be given a 30-day PrEP prescription, followed by a baseline research interview. After enrollment, participants will be seen for a 4-week follow-up visit to be evaluated for evidence of HIV seroconversion, adherence to medication, and clinical toxicity. Subsequent medical and research follow-up visits will occur at 3, 6, 9, and 12 months after enrollment. Quarterly medical visits will include testing for HIV and STIs as per clinic protocol. In addition, study participants will have creatinine levels checked and will receive brief adherence and risk reduction counseling. Participants who wish to discontinue PrEP will remain in the study and may resume PrEP. Those who discontinue PrEP and wish to leave the study will be asked to complete an exit interview.
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
New York
-
New York, New York, United States, 10027
- Harlem United
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New York, New York, United States, 10027
- Harlem Prevention Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- male at birth
- self-identify as Black, African American, Caribbean Black, African, or multiethnic Black
- are 18 years of age or older
- any male or transgender woman (TGW) partners in past 6 months;
- not in a monogamous partnership with a recently tested, HIV-negative man;
- have at least one of the following:
- reporting condomless anal and/or receptive neovaginal intercourse with at least one man or TGW in the past six months;
- any STI diagnosed or reported in past 6 months;
- is in on-going sexual relationship with an HIV-positive male or TGW partner;
- able to provide written informed consent in English;
- able to provide a street address or residence or phone number for themselves or two personal contacts who would know their whereabouts during participation in the study
Exclusion Criteria:
- current participation in any other PrEP study;
- having taken PrEP in programmatic context more than 3 months
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Enhanced PrEP Adherence
Enhanced PrEP Adherence: peer navigators, PrEP support group, on-line support group, text message reminders
|
|
Active Comparator: Standard PrEP Adherence
Standard PrEP Adherence: support groups, case management
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
adherence to daily Truvada use
Time Frame: twelve months after enrollment
|
this is a measure of PrEP adherence, to be implemented through self-reported adherence and collection of dried blood spots
|
twelve months after enrollment
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
percentage of sexual acts where condom was used
Time Frame: twelve months after enrollment
|
this is one measure of sexual risk behaviors.
Other such measures include number and type of sexual partner, specific sexual acts, drug/alcohol use during sex, transactional sex
|
twelve months after enrollment
|
number of correct knowledge items
Time Frame: twelve months after enrollment
|
this is one outcome measure from a knowledge, attitudes, and practices (KAP) questionnaire related to HIV prevention in general and PrEP in particular
|
twelve months after enrollment
|
number of participants remaining in care
Time Frame: end of 12-month study period
|
this is a measure of retention in care.
As each participants finishes his 12-month study period, retention will be determined by number of care visits completed.
|
end of 12-month study period
|
positive HIV test
Time Frame: during 12-month study period
|
this is a measure of seroconversion.
Participants who test HIV-positive at any quarterly care visit will exit the study and will be referred for HIV care.
|
during 12-month study period
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Paul W Colson, PhD, ICAP, Mailman School of Public Health, Columbia University
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- RNA Virus Infections
- Virus Diseases
- Infections
- Blood-Borne Infections
- Communicable Diseases
- Sexually Transmitted Diseases, Viral
- Sexually Transmitted Diseases
- Lentivirus Infections
- Retroviridae Infections
- Immunologic Deficiency Syndromes
- Immune System Diseases
- Slow Virus Diseases
- HIV Infections
- Acquired Immunodeficiency Syndrome
Other Study ID Numbers
- AAAO0852
- 5R01MH098723 (U.S. NIH Grant/Contract)
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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