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Toma de Decisiones Compartida para Tratar o Prevenir (STOP) el VIH en Poblaciones Penitenciarias (R33)

16 de octubre de 2026 actualizado por: Yale University

STOP (Toma de Decisiones Compartida para Tratar o Prevenir) VIH en Poblaciones Penitenciarias

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.

Descripción general del estudio

Estado

Reclutamiento

Condiciones

Intervención / Tratamiento

Descripción detallada

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.

Tipo de estudio

Intervencionista

Inscripción (Estimado)

400

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Estudio Contacto

Copia de seguridad de contactos de estudio

Ubicaciones de estudio

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

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

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

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Comparador activo: 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

Experimental: 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.

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Percentage of participants who initiate or re-initiate PrEP
Periodo de tiempo: 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
Periodo de tiempo: 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

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Percentage of participants that adhere to PrEP
Periodo de tiempo: 6 and 12 months

Percentage of participants that adhere to PrEP

6 and 12 months
Percentage of participants retaining on PrEP
Periodo de tiempo: 6 and 12 months

Percentage of participants retaining on PrEP

6 and 12 months
HIV incidence
Periodo de tiempo: 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
Periodo de tiempo: 6 and 12 months

Percentage of participants that adhere to ART

6 and 12 months
ART retention
Periodo de tiempo: 6 and 12 months

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

6 and 12 months
Substance use treatment
Periodo de tiempo: 6 and 12 months

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

6 and 12 months
HIV viral suppression
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 6 and 12 months

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

6 and 12 months
Days of using opioids
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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)
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 6 and 12 months

Mean days in custody/incarcerated

6 and 12 months
Recidivism: Mean days to return
Periodo de tiempo: 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)
Periodo de tiempo: 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
Periodo de tiempo: Baseline and 12 months

Percentage of participants diagnosed with SUD using DSM-5

Baseline and 12 months

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Colaboradores

Investigadores

  • Investigador principal: Sandra Springer, MD, Yale University

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

24 de noviembre de 2025

Finalización primaria (Estimado)

30 de diciembre de 2027

Finalización del estudio (Estimado)

1 de junio de 2028

Fechas de registro del estudio

Enviado por primera vez

30 de octubre de 2025

Primero enviado que cumplió con los criterios de control de calidad

30 de octubre de 2025

Publicado por primera vez (Actual)

31 de octubre de 2025

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

20 de octubre de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

16 de octubre de 2026

Última verificación

1 de octubre de 2026

Más información

Términos relacionados con este estudio

Otros números de identificación del estudio

  • 2000037052_a
  • 4R33DA060625-02 (Subvención/contrato del NIH de EE. UU.)

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

NO

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .