PrEP Impact Trial: A Pragmatic Health Technology Assessment of PrEP and Implementation

August 15, 2017 updated by: St Stephens Aids Trust

HIV pre-exposure prophylaxis (PrEP) is the use of anti-HIV medicines by HIV negative people in order to prevent them from becoming HIV positive if exposed to HIV.

Currently, the combination drug containing tenofovir and emtricitabine is licensed in Europe for use as HIV PrEP. We know from previous studies worldwide that this combination drug is very good at reducing the risk of HIV infection and several countries have implemented PrEP programmes to provide PrEP to individuals at high risk of HIV.

However, it is difficult to effectively plan for a national PrEP programme in England without knowing how many people will need PrEP, how many will want to take PrEP, and how long they will stay on PrEP.

In order to find this out, the PrEP Impact Trial will make PrEP available to at least 10,000 people over three years. HIV negative men and women attending sexual health clinics in England will have their risk of HIV assessed by their care team and be offered PrEP if they meet the eligibility criteria. Through the trial we will be able to measure how many attendees at sexual health clinics meet eligibility criteria for PrEP, how many of these take up the offer of PrEP and how long they remain on PrEP for.

There will not be any additional tests other than those recommended for the safe delivery of PrEP. These include tests for sexually transmitted infections (STIs) and HIV as well as urine and blood tests to monitor kidney function. Information about attendances and test results will be anonymously collected through the existing data reporting system that sexual health clinics currently use to report to Public Health England.

Study Overview

Status

Unknown

Conditions

Study Type

Observational

Enrollment (Anticipated)

10000

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

16 years and older (Child, Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

The participant populations for this trial will be men and women attending GUM clinics who belong to one of three populations recognised to be at high risk for HIV, namely:

A. Men (cisgender and transgender) and transgender women who:

  1. Have sex with men
  2. Have had an HIV negative test during an earlier episode of care in the preceding year
  3. Report condomless intercourse in the previous 3 months
  4. Affirm their likelihood of having condomless intercourse in the next 3 months

B. HIV negative partners of an HIV positive person when:

  1. The HIV positive partner is not known to be virally suppressed (<200 copies/ml for 6 months or more)
  2. Condomless intercourse is anticipated before treatment of the HIV positive partner takes effect

C.HIV negative persons who:

1. Are clinically assessed and considered to be at similar high risk of HIV acquisition as those with a serodiscordant partner who is not known to be virally suppressed

Description

Inclusion Criteria:

The participant populations for this trial will be men and women attending GUM clinics who belong to one of three populations recognised to be at high risk for HIV, namely:

A. Men (cisgender and transgender) and transgender women who:

  1. Have sex with men
  2. Have had an HIV negative test during an earlier episode of care in the preceding year
  3. Report condomless intercourse in the previous 3 months
  4. Affirm their likelihood of having condomless intercourse in the next 3 months

B. HIV negative partners of an HIV positive person when:

  1. The HIV positive partner is not known to be virally suppressed (<200 copies/ml for 6 months or more)
  2. Condomless intercourse is anticipated before treatment of the HIV positive partner takes effect

C.HIV negative persons who:

1. Are clinically assessed and considered to be at similar high risk of HIV acquisition as those with a serodiscordant partner who is not known to be virally suppressed

Participants will therefore be considered eligible for trial enrolment if they fulfil all the following individual eligibility criteria:

  1. Belongs to one of the three at high HIV risk populations described above
  2. Aged 16 years or over (no upper limit)
  3. Considered to be HIV negative on the day of enrolment
  4. Willing and able to provide informed consent
  5. Willing to adhere to the recommended PrEP regimen
  6. Willing to re-attend the trial clinic at appropriate intervals for risk assessment

Exclusion Criteria:

  1. An acute viral illness that could be due to HIV seroconversion
  2. Any contraindication to Tenofovir Disoproxil (TD)/ Emtricitabine (FTC)-

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
PrEP Eligibility
Time Frame: 3 years
The proportion of GUM clinic attendees meeting the eligibility criteria for PrEP
3 years
PrEP Eligibility (duration)
Time Frame: 3 years
The duration for which GUM clinic attendees are eligible for PreP
3 years
PrEP Uptake
Time Frame: 3 years
The proportion of PrEP eligible GUM clinic attendees prescribed PrEP
3 years
PrEP Uptake (duration)
Time Frame: 3 years
The duration for which eligible GUM clinic attendees use PrEP
3 years

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
HIV
Time Frame: 3 years
HIV diagnoses reported by sites and identified through the national surveillance dataset
3 years
STIs
Time Frame: 3 years
STI diagnoses (gonorrhoea, chlamydia, syphilis and hepatitis C) reported in the national surveillance dataset
3 years
Adverse Events
Time Frame: 3 years
  1. Serious suspected adverse drug reactions reported using the yellow card system
  2. Antiretroviral resistance associated mutations in participants with incident HIV infection
3 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Anticipated)

September 1, 2017

Primary Completion (Anticipated)

September 1, 2020

Study Completion (Anticipated)

September 1, 2020

Study Registration Dates

First Submitted

June 16, 2017

First Submitted That Met QC Criteria

August 15, 2017

First Posted (Actual)

August 18, 2017

Study Record Updates

Last Update Posted (Actual)

August 18, 2017

Last Update Submitted That Met QC Criteria

August 15, 2017

Last Verified

August 1, 2017

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

All data used in the study will be pseudo-anonymised and used for the purposes of determining the implementation of PrEP in England.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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 HIV Infections

Clinical Trials on This study is non-interventional.

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