Daily, Weekly, or Event-driven Doxycycline for STI Prevention Among Men Who Have Sex With Men (MSM) Engaging in Chemsex: The DOSE Non-inferiority Trial (DOSE)
The goal of this clinical trial is to learn if three different dosing strategies of doxycycline (daily, weekly, and on-demand) works to prevent sexually transmitted infections (gonorrhea, chlamydia, and syphilis) among men who use methamphetamine and who have sex with other men. The main question it aims to answer is:
Does daily, weekly, and on-demand doxycycline dosing strategies lower the incidence of quarterly STIs (gonorrhea, chlamydia, and syphilis)?
Participants will:
Take doxycycline either on-demand (within 72 hours after sex), daily, or weekly doxycycline for one year Visit the clinic once every 3 months to complete questionnaires, undergo HIV/STI testing, and collect samples. Additional visits may be needed to receive STI treatment.
Complete text surveys once every month
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
This study will evaluate the acceptability, effectiveness, and adherence of alternative doxycycline dosing strategies to optimize STI prophylaxis in this high-risk population. We will accomplish this through the following independent, yet interrelated Aims: 1) Determine effectiveness of fixed-dose daily, fixed-dose weekly, and event-driven dosing of doxycycline for STI prophylaxis; 2) Assess acceptability and preferences for doxycycline as STI prophylaxis through either fixed dose (daily or weekly) or event-driven (post-exposure) dosing strategies through individual interviews; 3) Evaluate and compare adherence and tolerability of daily, weekly, and event-driven doxycycline dosing strategies. We will conduct an open-label, non-inferior, randomized control trial (RCT) comparing fixed-dose daily, fixed-dose weekly, and event-driven doxycycline dosing strategies on quarterly incidence of STIs among MSM who use MA. We will screen 900 individuals to recruit a cohort of 300 MSM who self-report MA use in conjunction with condomless anal intercourse in the past month. At the Enrollment visit, participants will receive HIV, syphilis, and gonorrhea/chlamydia (GC/CT) testing as well as complete demographic and behavioral questionnaires. Enrolled participants will be randomly assigned 1:1:1 to either fixed-dose daily doxycycline (100mg daily; n=100), fixed-dose weekly doxycycline (200mg weekly; n=100), or event-driven doxyPEP (200mg taken up to 72 hours after a potential STI exposure; n=100; standard of care). All participants will participate in Quarterly follow-up visits where they will be assessed for HIV, bacterial STIs (GC/CT and syphilis), adherence to doxycycline, sexual behaviors/practices, substance use, nasal Staph aureus colonization and doxycycline resistance over 12 months. The primary outcome for this study will be quarterly incidence of, GC, CT, and/or early syphilis (defined as newly positive rapid plasma reagin [RPR] or four-fold rise in RPR titers), by arm.
研究の種類
研究の種類
入学 (推定)
入学
段階
段階
- フェーズ 4
連絡先と場所
研究連絡先
研究連絡先
- 名前:UCLA Vine Street Clinic
- 電話番号:(323) 461-3106
- メール:uclavsc@mednet.ucla.edu
研究場所
-
-
California
-
Los Angeles、California、アメリカ、90038
- UCLA Vine Street Clinic
-
コンタクト:
- UCLA Vine Street Clinic
- 電話番号:(323) 461-3106
- メール:uclavsc@mednet.ucla.edu
-
-
参加基準
適格基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Born male
- Age ≥ 18 years old
- Reports receiving an STI diagnosis (i.e., GC, CT, and/or syphilis) in the past 12 months
- Reports MA use in conjunction with CAI with a male partner in the 30 days prior to screening
- Not planning to relocate out of the study area in the 12-month follow-up period
- Willingness to engage in up to one year of repeated antibiotic exposure
- Willing and able to give written informed consent
Exclusion Criteria:
- Reported allergy to tetracyclines
- Current or anticipated use of a medication that interacts with doxycycline (prohibited medications listed below)
- Current or planned use of doxycycline for a prolonged period (> 2 weeks, with the exception of pre-enrollment doxyPEP)
- Prolonged antibiotic use (> 2 weeks, with the exception of pre-enrollment doxyPEP) in the 30 days prior to study enrollment
- Co-enrollment in any other concurrent study that may interfere with this study, such as an STI prevention trial, unless approved by the PI or designee
- Any other medical or psychiatric condition that, in the opinion of the PI or designee, may interfere with study participation or participant safety
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:防止
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
|---|---|
|
実験的:On-demand doxycycline
Participants randomized to on-demand doxycycline will be instructed to take doxycycline hyclate 200mg once as needed within 24 and up to 72 hours after sex (not to exceed 200mg in 24 hours). |
Participants randomized to receive on-demand doxycycline hyclate 200mg will be instructed to take doxycycline hyclate 200mg once as needed within 24 hours and up to 72 hours after sex (not to exceed 200mg in 24 hours) |
|
実験的:Weekly doxycycline
Participants randomized to receive fixed dose weekly doxycycline hyclate 200mg will be instructed to take doxycycline hyclate 200mg once weekly, regardless of sexual exposure. |
Participants randomized to receive weekly doxycycline hyclate 100mg will be instructed to take doxycycline hyclate 100mg once weekly |
|
実験的:Daily doxycycline
Participants randomized to receive fixed dose daily doxycycline hyclate 100mg will be instructed to take doxycycline hyclate 100mg once daily, regardless of sexual exposure. |
Participants randomized to receive fixed dose daily doxycycline hyclate 100mg will be instructed to take doxycycline hyclate 100mg once daily |
この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
時間枠 |
|---|---|
|
Quarterly incidence of chlamydia, gonorrhea, and/or early syphilis infection
時間枠:Quarterly incidence of C. trachomatis, N. gonorrhoeae, and/or early syphilis infection by laboratory-based diagnosis (over 1 year time period)
|
Quarterly incidence of C. trachomatis, N. gonorrhoeae, and/or early syphilis infection by laboratory-based diagnosis (over 1 year time period)
|
協力者と研究者
協力者
協力者
捜査官
捜査官
- 主任研究者:Cherie Blair, MD, PhD、University of California, Los Angeles
研究記録日
主要日程の研究
研究開始 (推定)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
その他の研究ID番号
- 26-1595
- 1R01DA066392-01A1 (米国 NIH グラント/契約)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
米国で製造され、米国から輸出された製品。
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