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Shared Decision Making to Treat Or Prevent (STOP) HIV i Retslige Populationer (R33)

16. oktober 2026 opdateret af: Yale University

STOP (Fælles Beslutningstagning for at Behandle eller Forebygge) HIV i Retslige Populationer

This study seeks to compare the effectiveness of two Patient Navigation models of care to evaluate the proportion who initiate PrEP/ART and substance use/substance use disorder (SU/SUD) treatment. A standardized Patient Navigation (PN) arm will be compared with a shared decision-making model in the form of Patient Choice (PC) through the offer of a menu of existing community-based health service delivery options. This design will offer providers, correctional and public health authorities, payers and policy makers' timely and relevant data to assess the effectiveness of Patient Navigation and Patient Choice models of care as potentially useful re-entry and relapse prevention treatment options.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This study will be done in two phases. Aim 1, the R61 portion of the project will be a Pilot Study, and Aim 2, the R33 portion of the project will be a Randomized Controlled Trail informed by the pilot.

The focus of this registration is Aim 2, the randomized controlled trial. The Aim 1 (R61) portion is registered with NCT06439329. In Aim 2 (R33), investigators will evaluate standard PN compared to PN+PC on participant outcomes, implementation outcomes and costs associated with implementing the study.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

400

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

    • Connecticut
      • New Haven, Connecticut, Forenede Stater, 06510
        • Rekruttering
        • Yale School of Medicine
        • Ledende efterforsker:
          • Sandy Springer, MD
    • Kentucky
      • Lexington, Kentucky, Forenede Stater, 40506
        • Rekruttering
        • College of Medicine at the University of Kentucky
        • Ledende efterforsker:
          • Michele Staton, PhD, MSW
    • Texas
      • Dallas, Texas, Forenede Stater, 75390
        • Rekruttering
        • University of Texas Southwestern Medical Center (UTSW)
        • Ledende efterforsker:
          • Ank Nijhawan, MD, MPH
      • Fort Worth, Texas, Forenede Stater, 76109
        • Rekruttering
        • Texas Christian University's (TCU) School of Medicine
        • Ledende efterforsker:
          • Kevin Knight,, PhD

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • able to provide written informed consent in English or Spanish;
  • living in the community of Western, CT, Dallas and Tarrant Counties in TX and Madison County, KY (potential for Fayette county as well);
  • Those with current justice involvement (with in the past 12 months) (e.g., prison, jail, community supervision);
  • willing to have HIV testing to determine negative or positive status;
  • persons with HIV who report not currently taking ART in past 6 months OR persons who test negative for HIV who report not taking PrEP that have a PrEP indication in past 12 months, including (i) condomless sexual intercourse; and/or (ii) sharing IDU equipment with HIV positive or unknown status partner; and/or (iii) bacterial STI and;
  • Having a history of opioid and/or stimulant use in the last 12 months within the community.

Exclusion Criteria:

  • severe medical or psychiatric disability making participation unsafe;
  • unable to provide consent.
  • persons self-reporting pregnancy

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Standard Patient Navigation (PN)

PNs are "near-peer" professionals who have shared lived experiences with participants and help them overcome barriers to accessing and engaging in quality care. PNs are trained and linked to PrEP/ART and SUD services. This manualized PN approach provides a complete assessment of participant needs, goal setting, and help with appointment scheduling.

Standard of care

Eksperimentel: PN + Patient Choice (PC) (PN+PC)

PNs working in the PN + PC arm will be trained to engage participants in selecting from a menu of service options in their community. This menu of SUD and HIV prevention and treatment service delivery options will be created through bolstering and working with our Community Advisory Boards (CAB). PNs will also be trained to discuss sexual and substance use history with participants in order to provide education and motivation towards starting PrEP/ART and SUD treatment.

Standard of care

Participants can select from a menu of options including brick and mortar services, Mobile Health Unit (MHU) or telehealth services.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Percentage of participants who initiate or re-initiate PrEP
Tidsramme: 6 months

Percentage of participants not living with HIV who initiate or re-initiate PrEP within the 6-month intervention period by self report

6 months
Percentage of participants who initiate or re-initiate ART
Tidsramme: 6 months

Percentage of participants living with HIV who initiate or re-initiate ART within the 6-month intervention period by self report

6 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Percentage of participants that adhere to PrEP
Tidsramme: 6 and 12 months

Percentage of participants that adhere to PrEP

6 and 12 months
Percentage of participants retaining on PrEP
Tidsramme: 6 and 12 months

Percentage of participants retaining on PrEP

6 and 12 months
HIV incidence
Tidsramme: 6 and 12 months

HIV incidence [binary] for those testing negative using rapid point of care (POC) test over time

6 and 12 months
Percentage of participants that adhere to ART
Tidsramme: 6 and 12 months

Percentage of participants that adhere to ART

6 and 12 months
ART retention
Tidsramme: 6 and 12 months

For persons living with HIV (PLH), ART retention [binary]

6 and 12 months
Substance use treatment
Tidsramme: 6 and 12 months

Percentage of participants engaged in substance use disorder (SUD) treatment

6 and 12 months
HIV viral suppression
Tidsramme: 6 months

For PLH, HIV viral suppression, for those with HIV at time of randomization: the percent who maintain or achieve HIV viral load < 200 copies/mL at 6 months

6 months
Retention in HIV PrEP/ART
Tidsramme: 6 months

Retention in HIV PrEP/ART care [binary]: defined as attending 2 or more visits in 6-months

6 months
Number of Participants Who Had Any Needle Sharing Activity to Assess HIV Risk Behavior
Tidsramme: 6 and 12 months

Number of Participants Who Had Any Needle Sharing Activity

6 and 12 months
Number of Participants Who Had Sex Without a Condom to assess HIV Risk Behavior
Tidsramme: 6 and 12 months

Number of Participants Who Had Vaginal or Anal Sex Without a Condom

6 and 12 months
Days of using opioids
Tidsramme: 6 and 12 months

Measured by Timeline Followback, which assesses self-reported alcohol and other drug use including opioid use

6 and 12 months
Number of participants with with overdose events
Tidsramme: 6 and 12 months

Number of participants with non-fatal and fatal overdose events

6 and 12 months
Percentage of participants with retention in SUD treatment
Tidsramme: 6 and 12 months

Retention in SUD treatment including but not exclusive to Medication for Opioid Use Disorder (MOUD) for Opioid Use Disorder (OUD)

6 and 12 months
Quality of Life assessed using PROMIS-PROPr
Tidsramme: 6 and 12 months

PROMIS-PROPr assesses general societal health. Total summary score ranges from -0.022, worse than dead, to 1, perfect health.

6 and 12 months
Change in Depression assessed using Patient Health Questionnaire-9 (PHQ-9)
Tidsramme: 6 and 12 months

Depression will be assessed using the PHQ-9. PHQ-9 is a 9-item validated questionnaire used to screen for depression with a range of scores from 0-45. A cumulative score of ≥10 is considered positive with lower scores indicating no or mild anxiety.

6 and 12 months
Recidivism: Reasons
Tidsramme: 6 and 12 months

Number of participants per reason for arrest/ incarceration/return-to-custody

6 and 12 months
Recidivism: Mean days in custody/incarcerated
Tidsramme: 6 and 12 months

Mean days in custody/incarcerated

6 and 12 months
Recidivism: Mean days to return
Tidsramme: 6 and 12 months

Mean days to return to custody/incarcerated

6 and 12 months
HIV and SU Stigma assessed using Substance Use Stigma Mechanisms Scale (SU-SMS)
Tidsramme: 6 and 12 months

Mean score for Enacted (6 items), Anticipated (6 items), and Internalized (6 items) scales. Each scale is scored 1-5, with higher scores indicating greater endorsement of substance use stigma

6 and 12 months
Percentage of participants diagnosed with SUD
Tidsramme: Baseline and 12 months

Percentage of participants diagnosed with SUD using DSM-5

Baseline and 12 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Samarbejdspartnere

Efterforskere

  • Ledende efterforsker: Sandra Springer, MD, Yale University

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

24. november 2025

Primær færdiggørelse (Anslået)

30. december 2027

Studieafslutning (Anslået)

1. juni 2028

Datoer for studieregistrering

Først indsendt

30. oktober 2025

Først indsendt, der opfyldte QC-kriterier

30. oktober 2025

Først opslået (Faktiske)

31. oktober 2025

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

20. oktober 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

16. oktober 2026

Sidst verificeret

1. oktober 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 2000037052_a
  • 4R33DA060625-02 (U.S. NIH-bevilling/kontrakt)

Plan for individuelle deltagerdata (IPD)

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