- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04038060
The PrEP (Pre-exposure Prophylaxis) SMART Study
August 31, 2023 updated by: Connie Celum, University of Washington
Evaluation of Stepped PrEP (Pre-exposure Prophylaxis) Adherence Support for Young South African Women Using a SMART Design
The PrEP SMART study is testing a stepped model of scalable adherence support strategies in South African young women who initiate PrEP using a SMART (sequential multiple assignment randomized trial) design.
Study Overview
Status
Completed
Conditions
Detailed Description
Women enrolled in the study will be randomized to standard of care adherence support (brief counseling) and either WhatsApp groups or weekly two-way SMS messages.
Two months after PrEP initiation, tenofovir drug levels will be measured to determine if participants have achieved high adherence based on their initial randomization.
Women with high adherence (i.e., TFV-DP >/=500 fmol/punch from dried blood spots [DBS]) will continue with the adherence support to which they were initially randomized.
Participants with low adherence (i.e., TFV-DP <500 fmol/punch from DBS) will continue initial randomization (WhatsApp or two-way SMS) plus be randomized to more one of two more intensive adherence support interventions - continued monthly visits with adherence and problem-focused counseling at months 3-8 or quarterly visits between months 3-9 with feedback about adherence based on drug levels at months 3 and 6.
Study Type
Interventional
Enrollment (Actual)
350
Phase
- Not Applicable
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
- Name: Jennifer Morton, MPH, MSW
- Phone Number: 12065203832
- Email: jfmorton@uw.edu
Study Contact Backup
- Name: Jennifer Velloza, PhD, MPH
- Phone Number: 206-520-3800
- Email: jvelloza@uw.edu
Study Locations
-
-
-
Johannesburg, South Africa
- Wits Reproductive Health and HIV Institute
-
-
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 to 23 years (Adult)
Accepts Healthy Volunteers
Yes
Description
Inclusion Criteria:
- Female at birth
- Age 18-25 years
- Per participant report, sexually active, defined as having vaginal or anal intercourse at least once in the month prior to screening
- Literate in one or more of the study languages
- Willing and able to provide informed consent
- Able and willing to provide adequate locator information
- Regular access to a mobile phone with SMS and WhatsApp capacity
- Agrees not to participate in other research studies involving drugs or medical devices for the duration of study participation
Exclusion Criteria:
- Planning to relocate in the next 12 months
- Has a job or other obligations that would require long absences from the area (> 4 weeks at a time) for 12 months
- A reactive or positive HIV test at Enrollment
- Any reported PrEP use within the last 6 months
- Concomitant participation in a clinical trial using investigational agents, including placebo-controlled clinical trials using such agents
- Prior participation in the active arm, or current participation in any arm, of an HIV vaccine trial
- Positive pregnancy test
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
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Sequential Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: WhatsApp Group
Participants will be assigned to participate in a WhatsApp Group
|
Participants will receive peer adherence support through WhatsApp groups
|
Experimental: 2-way SMS
Participants will be assigned to receive weekly 2-way SMS initiated by the study team
|
Participants will receive healthcare worker adherence support through 2-way SMS
|
Experimental: 2-way SMS and monthly counseling sessions
Participants will be assigned to receive weekly 2-way SMS initiated by the study team and monthly counseling sessions
|
Participants will receive healthcare worker adherence support through 2-way SMS
Participants will receive monthly counseling on a variety of issues that may be impacting their PrEP adherence
|
Experimental: 2-way SMS and drug level feedback
Participants will be assigned to receive weekly 2-way SMS initiated by the study team and drug level feedback
|
Participants will receive healthcare worker adherence support through 2-way SMS
Participants will receive adherence counseling based on tenofovir drug levels
|
Experimental: WhatsApp Group and monthly counseling sessions
Participants will be assigned to participate in a WhatsApp Group and monthly counseling sessions
|
Participants will receive peer adherence support through WhatsApp groups
Participants will receive monthly counseling on a variety of issues that may be impacting their PrEP adherence
|
Experimental: WhatsApp Group and drug level feedback
Participants will be assigned to participate in a WhatsApp Group and drug level feedback
|
Participants will receive peer adherence support through WhatsApp groups
Participants will receive adherence counseling based on tenofovir drug levels
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
PrEP Adherence
Time Frame: 9 months
|
Evaluation of the proportion of young women who adhere well to PrEP in each of the intervention arms.
|
9 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
PrEP persistence
Time Frame: 12 months
|
Assessment of the proportion of young women who achieve high adherence.
|
12 months
|
Correlates of PrEP adherence
Time Frame: 12 months
|
Assessment of the correlates of PrEP adherence, after adjusting for study arm.
|
12 months
|
PrEP discontinuation
Time Frame: 12 months
|
Assessment of the timing of PrEP discontinuation in young women who discontinue PrEP.
|
12 months
|
PrEP decision making
Time Frame: 12 months
|
Qualitative exploration of the factors that influence women's decisions to adhere to PrEP.
|
12 months
|
Intervention satisfaction
Time Frame: 12 months
|
Qualitative exploration of women's satisfaction with their assigned intervention(s).
|
12 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Sinead Delany-Moretlwe, MBChB, PhD, Wits Reproductive Health and HIV Institute
- Principal Investigator: Connie Celum, MD, MPH, University of Washington
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the 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 (Actual)
May 16, 2019
Primary Completion (Actual)
October 27, 2021
Study Completion (Actual)
January 25, 2022
Study Registration Dates
First Submitted
June 19, 2019
First Submitted That Met QC Criteria
July 26, 2019
First Posted (Actual)
July 30, 2019
Study Record Updates
Last Update Posted (Actual)
September 1, 2023
Last Update Submitted That Met QC Criteria
August 31, 2023
Last Verified
August 1, 2023
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
- Urogenital Diseases
- Genital Diseases
- HIV Infections
- Acquired Immunodeficiency Syndrome
Other Study ID Numbers
- STUDY00006439
- R01MH114544 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
YES
IPD Plan Description
Data from the PrEP SMART Study will be available at the end of the project by contacting the Principal Investigators.
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/AIDS
-
University of MinnesotaWithdrawnHIV Infections | HIV/AIDS | Hiv | AIDS | Aids/Hiv Problem | AIDS and InfectionsUnited States
-
University of California, San DiegoNational Institute of Allergy and Infectious Diseases (NIAID)Completed
-
University of Massachusetts, BostonCompleted
-
Stanford UniversityJanssen Services, LLCCompleted
-
ViiV HealthcareJohns Hopkins University; Pfizer; Vanderbilt University; University of North Carolina...Completed
-
Medical College of WisconsinCompleted
-
Emory UniversityCompleted
-
Rhode Island HospitalUnknown
-
Tibotec Pharmaceuticals, IrelandCompleted
-
Lampiris, Harry W., M.D.AbbottUnknown
Clinical Trials on WhatsApp Group
-
Lions Club International FoundationCompletedDiabetic Macular EdemaIndia
-
The University of Hong KongCompletedSmoking CessationHong Kong
-
Inonu UniversityActive, not recruiting
-
The University of Hong KongUnknown
-
Adiyaman University Research HospitalCompletedCommunicationTurkey
-
Nabiha RamadanUniversitat de GironaCompletedBreast Feeding | Exclusive Breastfeeding | SalutogenesisLebanon
-
Infectious Diseases Research Collaboration, UgandaMakerere UniversityRecruitingHIV Disease ProgressionUganda
-
Necmettin Erbakan UniversityRecruitingPulmonary Disease, Chronic ObstructiveTurkey
-
University of MinnesotaNational Heart, Lung, and Blood Institute (NHLBI); Syracuse University; Liverpool... and other collaboratorsRecruitingIncrease Repeat Blood Donation Attempts Among First-time DonorsUnited States