- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03235518
A Combination HIV Prevention Strategy for Young Women at Risk for HIV (IPrEP)
Study Overview
Status
Conditions
Detailed Description
Despite remarkable advances in the global HIV response with 17 million persons, out of nearly 37 million living with HIV, who have initiated antiretroviral therapy (ART) in low- and middle-income countries (LMIC) as of end of 2015, there were an estimated 5,700 new HIV infections each day and a total of 2.1 million new HIV infections in 2015, of which 66% were in sub-Saharan Africa (SSA). Key populations within the generalized HIV epidemics in SSA, including female sex workers (FSW), have received insufficient attention, with data indicating that they are at disproportionate risk with limited access to prevention and treatment services. Globally, new infections among key populations and their sexual partners accounted for 36% of all new HIV infections in 2015. HIV prevalence among FSW is 29.3% worldwide. While reliable HIV prevalence estimates are lacking, younger FSW <25 years may be at significantly greater risk due to the confluence of biological, behavioral and structural risk factors.6 Mathematical modeling suggests that the proportion of new HIV infections attributable to sex work is likely to increase over time.
In settings where key populations contribute substantially to HIV burden, as in Kenya, effective integrated prevention strategies are urgently needed for populations such as FSW and can have a substantial impact on reducing new HIV infections.
In 2012, HIV prevalence among Kenyan 15-64 year olds was 5.6%, with 1,192,000 people living with HIV, but was markedly higher (15.1%) in the region of Kenya, formerly named Nyanza Province. HIV prevalence is 14.1% among FSW and 7.6% among male clients of sex workers (MC). FSW contribute significantly to new HIV infections in Kenya,14 with modelled estimates showing that 1 in 3 new HIV infections can be attributed to key populations.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
-
-
-
Kisumu, Kenya
- Kisumu, Kenya
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
FSW. Inclusion criteria for the structured interviews, FGDs and IDI are identical.
- Report being female or transgender women born make who have sex with men
- Report being HIV-negative or unknown status
- Report being between 18-24 years of age
- Report residing or working in study community
- Reports exchange sex for goods, money, flavors or other services in past 3 months
- Willing to allow audio-recording of FGDs or IDI
- Able to complete study procedures in English, Kiswahili or Dhuluo
Male Clients
- Male
- Report being >=18 years of age
- Report exchanging goods, money, favors or other services for sex in past 3 months
- Willing to allow audio-recording of IDI
- Able to complete study procedures in English, Kiswahili or Dhuluo
Health Care Providers
- Currently working as nurse or clinical officer at a clinic or other facility likely to offer PrEP
- Report being >= 18 years of age
- Willing to allow audio-recording of IDI
- Able to complete study procedures in English
Exclusion Criteria:
- Individuals who do not meet the inclusion criteria
- Individuals who in the opinion of the investigators would interfere with adherence to study study requirements
- FSW participating in FGD are not eligible for participation in IDI
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
---|
Structure Interviews with FSW
Structured interviews with 200 purposively sampled FSW will be conducted.
These interviews will be conducted prior to focus group discussion (FGD) and in-depth qualitative interview (IDI) with FSW.
Structured interviews will take approximately 45-60 minutes to complete and will be administered privately in Kiswahili, Dholuo or English by trained female research staff.
Quantitative interviews will be administered to conduct an assessment of FSW sociodemographics, sexual behaviour patterns and HIV-related knowledge, attitudes and practices regarding HIV prevention and other factors that might affect initiation and adherence to PrEP use, ability to use PrEP covertly, HIV testing history, mobility patterns, social networks, pregnancy intentions, ability to use condoms consistently with clients, and regular partners, and interpersonal violence from clients, regular partners and the police.
|
Focus Group Discussions with FSW
Three to five FGDs of up to 10 FSW per group will be conducted.
These FGD will take place prior to FSW IDI.
FSW who participated in FGDs will be ineligible for participation in the IDI.
All group discussions will last approximately 1.5 to 2 hours and be conducted in Kiswahili, Dholuo or English.
Each group discussion will be facilitated by trained female research staff and held in a private space at a pre-specified location.
The themes that will be explored in the FGDs include: FSW social networks, participation in PrEP studies, barriers and facilitators to PrEP use and use of resource transfers for PrEP adherence.
In addition, participants will complete a brief demographic survey.
|
In-Depth Qualitative Interviews with FSW
30 IDI will be conducted with FSW.
FSW who participated in FGDs will be ineligible for participation in the IDI.
All in-depth interviews will be conducted by trained female research staff using a semi-structured interview guide.
All interviews will be held in a private space at a pre-specified location within the community.
The topics that will be discussed in the IDI with FSW include demographics, social support, dynamics of sex work, HIV prevention methods (including condom use), perception of HIV risk and development of PrEP intervention.
|
In-Depth Qualitative Interviews with MC
30 IDI will be conducted with MC.
All IDI will last approximately 60-90 minutes and be conducted in Kiswahili, Dholuo, or English.
Each interview will be conducted by a trained male research staff using semi-structured interview guide.
All interviews will be held in a private space at a pre-specified location.
Topics include demographics, relationships with FSW, HIV prevention methods (including use of condoms), perception of HIV risk and development of PrEP intervention.
|
In-Depth Qualitative Interviews with HCPs
30 IDI will be conducted with health care provider (HCP).
All IDI will last approximately 60-90 minutes and be conducted in English.
Each interview will be conducted by trained research staff using a semi-structured interview guide.
Interviews will be held in a private space at the health facility where they work or another venue preferred by the HCP.
Topics include demographics, health care needs of FSW and sources of care, HIV prevention needs of FSW, PrEP for FSW and training needs for HCP.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Percentage of FSW participants who would be willing to participate in HIV prevention research
Time Frame: 6 months
|
To inform prevention interventions for FSW, we will assess the percentage of FSW willing to participate in HIV prevention research or a PrEP study
|
6 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Percentage of MC participants who would be willing to participate in HIV prevention research
Time Frame: 6 months
|
To inform prevention interventions, we will assess the percentage of MC willing to participate in HIV prevention research
|
6 months
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Wafaa M. El-Sadr, MD, MPH, MPA, Columbia University
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 (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
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
- AAAR0256
- R01MH110051 (NIH)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Human Immunodeficiency Virus
-
Merck Sharp & Dohme LLCWithdrawnHIV-1 | Immunodeficiency Virus Type 1, Human | Human Immunodeficiency Virus Type 1 | Human Immunodeficiency Virus 1
-
MacroGenicsNational Institute of Allergy and Infectious Diseases (NIAID); National Institutes... and other collaboratorsActive, not recruitingHuman Immunodeficiency Virus I Infection | Immunodeficiency Virus Type 1, Human | Human Immunodeficiency Virus Type 1United States
-
National Institute of Allergy and Infectious Diseases...CompletedHuman Immunodeficiency Virus (HIV) | Human Immunodeficiency Virus PreventionUnited States
-
EMD SeronoCompletedHuman Immunodeficiency Virus Infections | Human Immunodeficiency Virus-associated Adipose Redistribution Syndrome (HARS)
-
EMD SeronoCompletedHuman Immunodeficiency Virus Infections | Human Immunodeficiency Virus-associated Adipose Redistribution Syndrome (HARS)
-
ViiV HealthcareGlaxoSmithKlineCompletedInfection, Human Immunodeficiency Virus | Infections, Human Immunodeficiency Virus and HerpesviridaeUnited States
-
bioLytical LaboratoriesNot yet recruitingHuman Immunodeficiency Virus I Infection | Human Immunodeficiency Virus II Infection
-
Janssen R&D IrelandCompletedHuman Immunodeficiency Virus Type 1United States, France, United Kingdom, Belgium, Spain, Switzerland, Sweden, Canada, Puerto Rico, Poland
-
ViiV HealthcareGlaxoSmithKlineCompletedInfection, Human Immunodeficiency VirusUnited States
-
ViiV HealthcareGlaxoSmithKlineTerminatedInfection, Human Immunodeficiency VirusSpain, France, Germany