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Comprehensive HIV Prevention Package for MSM in Port Elizabeth

4. juli 2017 opdateret af: Patrick S Sullivan, Emory University
The purpose of this study is to evaluate the acceptability and uptake of a combination package of biomedical, behavioral and community-level HIV prevention interventions and services for men who have sex with men (MSM) in South Africa.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

The objective of the Sibanye Health Project is to develop and evaluate a combination package of biomedical, behavioral and community-level HIV prevention interventions and services for men who have sex with men (MSM) in Africa. Experience implementing the prevention interventions and preliminary data collected regarding the acceptability of the HIV prevention package will be used to develop a proposal to design a larger efficacy trial to test the combination HIV prevention package for MSM.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

101

Fase

  • Ikke anvendelig

Kontakter og lokationer

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

Studiesteder

  • Sydafrika
      • Port Elizabeth, Sydafrika
        • Human Sciences Research Council

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

Ja

Køn, der er berettiget til at studere

Han

Beskrivelse

Inclusion Criteria:

  • Male sex at birth
  • Anal sex with another man in the past 12 months
  • 18 years of age or older
  • Resident of the study city, Port Elizabeth
  • Able to complete study instruments, with or without assistance, in English, Xhosa or Afrikaans
  • Willing to provide contact information
  • Has a phone

Exclusion Criteria:

  • Not male sex at birth
  • No self-reported anal sex with a man in the past 12 months
  • Less than 18 years of age
  • Not a resident of the study city
  • Plans to move from the study city within the year after enrollment
  • Not able to complete study instructions, with or without assistance, in English, Xhosa or Afrikaans
  • Not willing to provide contact information
  • Does not have a phone

Additional Inclusion and Exclusion Criteria for participants on PrEP:

PrEP Inclusion Criteria:

  • Identified as high-risk for HIV by the provider by meeting one or more of the criteria below:
  • Have multiple partners
  • Engage in transactional sex, including sex workers
  • Use or abuse drugs
  • Drink alcohol heavily
  • Had more than 1 episode of a STI in the last year
  • Is the HIV-negative partner in a discordant relationship, especially if the HIV-positive partner is not on antiretroviral therapy (ART)
  • Is in a non-monogamous concordant relationship with a HIV-negative partner
  • Is unable or unwilling to achieve consistent use of male condoms
  • No contra-indications to Emtricitabine/Tenofovir Disoproxil Fumarate (FTC/TDF)
  • Calculated creatinine clearance of at least 60 mL/min
  • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) < 2 x upper limit of normal (ULN)
  • Hepatitis B surface antigen (HBsAg) negative
  • Motivated to follow PrEP prescribing guidelines
  • Willing to adhere to daily oral dosing
  • Willing to attend PrEP maintenance visits every 3 months

PrEP Exclusion Criteria:

  • HIV positive
  • Signs or symptoms suggestive of acute HIV infection
  • Have baseline creatinine clearance <60 ml/min
  • Are unwilling to follow PrEP prescribing guidelines
  • Are unwilling to attend PrEP maintenance visits every 3 months
  • Are known to have hypertensives or diabetes
  • Are hepatitis B susceptible (test HBsAg and HBsAb negative) and refuse to take a hepatitis B vaccine series
  • Any contraindication to taking FTC/TDF
  • Proteinuria 2+ or greater at screening
  • Glucosuria 2+ or greater at screening
  • Use of antiretroviral (ARV) therapy (e.g., for PEP or PrEP) in the 90 days prior to study entry

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Ikke-randomiseret
  • Interventionel model: Crossover opgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: HIV+ subjects
Men who test positive for HIV will receive a comprehensive package of HIV prevention services, including condom choices, condom-compatible lubricant choices, risk-reduction counseling, couples HIV counseling and testing, and linkage to care
Adfærdsmæssigt: Kondom valg
Mænd vil modtage kondompakken, der inkluderer et udvalg af stilarter, størrelser, funktioner og farver ved deres baseline-besøg, og vil være i stand til at få flere kondomer gratis til enhver tid efter besøget ved at komme til en studieklinik i klinikkens åbningstid, eller under et planlagt studiebesøg.
Adfærdsmæssigt: Valg af kondomkompatible smøremidler
Mænd vil modtage kondomkompatibelt glidecreme, der vil omfatte forskellige typer smøremiddel (f.eks. silikonebaseret) og forskellige emballager (individuelle breve eller flade, diskrete pakker) ved deres baseline studiebesøg, og deltagerne vil kunne få adgang til forbedret kondomkompatibel smøremiddel på et hvilket som helst tidspunkt efter det besøg ved at komme til en studieklinik i kliniktiden eller under et planlagt studiebesøg.
Adfærdsmæssigt: Par HIV rådgivning og test (CVCT)
Deltagerne vil blive inviteret til at planlægge par frivillige hiv-rådgivnings- og testaftaler (CVCT) med en klinikrådgiver på et hvilket som helst tidspunkt, efter at de har afsluttet deres baseline studiebesøg.
Andet: Linkage to care
Men will be linked to needed services including HIV care and treatment for positives identified at baseline or during the study, including antiretroviral medications, and mental health services. At the end of their baseline visit, participants will receive service referral handouts for HIV care and treatment, mental health services, and other resources, as appropriate. Men who test positive for sexually transmitted infections (STIs )will be treated at the clinic site.
Adfærdsmæssigt: Risk-reduction counseling
Risk-reduction counseling will be provided to all men at baseline and additionally at 3, 6, and 12 month visits, with an additional counseling session for men on PrEP at their initiation visit (either month 1 or 4), their 1-month follow-up visit (either month 2 or 5) and at their 9 month visit. Risk reduction counseling will be client-centered counseling, according to CDC's Fundamentals of HIV Prevention Counseling protocol.
Eksperimentel: HIV- subjects

Men who test negative for HIV will receive a comprehensive package of HIV prevention services, including condom choices, condom-compatible lubricant choices, enhanced HIV testing options, risk-reduction counseling, couples HIV counseling and testing, linkage to care, and screening for and offering of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).

If men test positive for HIV during the study, they will be transitioned into the HIV+ subjects arm.
Adfærdsmæssigt: Kondom valg
Mænd vil modtage kondompakken, der inkluderer et udvalg af stilarter, størrelser, funktioner og farver ved deres baseline-besøg, og vil være i stand til at få flere kondomer gratis til enhver tid efter besøget ved at komme til en studieklinik i klinikkens åbningstid, eller under et planlagt studiebesøg.
Adfærdsmæssigt: Valg af kondomkompatible smøremidler
Mænd vil modtage kondomkompatibelt glidecreme, der vil omfatte forskellige typer smøremiddel (f.eks. silikonebaseret) og forskellige emballager (individuelle breve eller flade, diskrete pakker) ved deres baseline studiebesøg, og deltagerne vil kunne få adgang til forbedret kondomkompatibel smøremiddel på et hvilket som helst tidspunkt efter det besøg ved at komme til en studieklinik i kliniktiden eller under et planlagt studiebesøg.
Adfærdsmæssigt: Par HIV rådgivning og test (CVCT)
Deltagerne vil blive inviteret til at planlægge par frivillige hiv-rådgivnings- og testaftaler (CVCT) med en klinikrådgiver på et hvilket som helst tidspunkt, efter at de har afsluttet deres baseline studiebesøg.
Andet: Linkage to care
Men will be linked to needed services including HIV care and treatment for positives identified at baseline or during the study, including antiretroviral medications, and mental health services. At the end of their baseline visit, participants will receive service referral handouts for HIV care and treatment, mental health services, and other resources, as appropriate. Men who test positive for sexually transmitted infections (STIs )will be treated at the clinic site.
Adfærdsmæssigt: Risk-reduction counseling
Risk-reduction counseling will be provided to all men at baseline and additionally at 3, 6, and 12 month visits, with an additional counseling session for men on PrEP at their initiation visit (either month 1 or 4), their 1-month follow-up visit (either month 2 or 5) and at their 9 month visit. Risk reduction counseling will be client-centered counseling, according to CDC's Fundamentals of HIV Prevention Counseling protocol.
Medicin: Emtricitabine/Tenofovir Disoproxil Fumarate (FTC/TDF)

FTC/TDF is a once daily oral tablet taken with or without food. The tablet includes 200 mg of emtricitabine (FTC) and 300 mg of tenofovir disoproxil fumarate (TDF).

For men who meet eligibility criteria, Pre-exposure prophylaxis (PrEP) with Emtricitabine/Tenofovir Disoproxil Fumarate (FTC/TDF) will be made available beginning one month into the study. Men who express interest and meet eligibility criteria at their baseline visit can initiate PrEP at 1 month if they test negative for HIV. For men with extenuating circumstances, whose risk profile changes, of those who become more comfortable with the PrEP intervention through enrollment in the study, PrEP will be available to initiate at the 4 month visit.

Andre navne:
  • Truvada
Andet: HIV Testing
Rapid HIV testing at multiple time points
Procedure: Post-exposure prophylaxis (PEP)
Two to three antiretroviral medicines as soon as possible (recommended is emtricitabine/tenofovir disoproxil fumarate plus either raltegravir or dolutegravir), but no more than 72 hours (3 days) after one may have been exposed to HIV, to try to reduce the chance of becoming HIV-positive. They must be taken for 28 days.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Retention in the cohort
Tidsramme: 12 months
Will assess the ability of the study to retain participants for full study period. This will be measured by the proportion of enrolled participants who attend all subsequent study visits through the 12-month visit.
12 months
Use of PrEP
Tidsramme: 6 months
Will assess uptake of PrEP by study participants. This will be measured as the proportion of enrolled participants eligible for PrEP at the 3 and 6-month study visits who choose to initiate PrEP at those visits.
6 months
Incident HIV infection
Tidsramme: 12 months
This will be measured as the number of seroconversions during follow-up among those who are HIV-uninfected at baseline.
12 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Condom use
Tidsramme: 3 months
Measured as the proportion of anal intercourse that is protected by condoms in the prior 3 months as self-reported reported in the questionnaire at each study visit.
3 months
Lubricant use
Tidsramme: 3 months
Measured as the proportion of condom-protected anal intercourse in the prior for 3 months for which condom-compatible lubricant is used as self-reported in the questionnaire at each study visit.
3 months
VCT and CVCT uptake
Tidsramme: 12 months
Measured as the number of times participants report HIV testing in the study period as part of the study visits and outside study visits compared to the number of time participants reported HIV testing in the year prior at baseline.
12 months
Serodiscordant unprotected anal intercourse (UAI)
Tidsramme: 3 months
Measured as self-reported UAI in the last 3 months with a partner of positive or unknown HIV status as self-reported in the questionnaire at each study visit, pre- and post-intervention.
3 months
Acceptability of PEP
Tidsramme: 12 months
Measured as the proportion of men who report an eligible exposure who accept and initiate PEP.
12 months
MSM-specific provider training
Tidsramme: 12 months
Measured as the proportion of providers who are offered training who accept the training.
12 months

Samarbejdspartnere og efterforskere

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

Sponsor

Emory University

Efterforskere

  • Ledende efterforsker: Stefan Baral, MD, MPH, CCFP, Johns Hopkins Bloomberg School of Public Health
  • Ledende efterforsker: Nancy Phaswanamafuya, PhD, Human Sciences Research Council

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)

1. maj 2015

Primær færdiggørelse (Faktiske)

1. oktober 2016

Studieafslutning (Faktiske)

1. marts 2017

Datoer for studieregistrering

Først indsendt

18. maj 2015

Først indsendt, der opfyldte QC-kriterier

18. maj 2015

Først opslået (Skøn)

20. maj 2015

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

6. juli 2017

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. juli 2017

Sidst verificeret

1. juli 2017

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • IRB00079727

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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