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PHASES: Provision of HIV Treatment at ATN Sites: An Evaluation for Stakeholders

2017年2月27日 更新者:University of North Carolina, Chapel Hill
This is an observational study involving retrospective and prospective medical record review covering a total maximum of 104 weeks (24 months) per subject. An Audio Computer- Assisted Self-Interview (ACASI) at study entry will assess demographic and psychosocial variables of study subjects. Data will also be collected to assess clinic level variables. Definitions of engagement, prescription of antiretroviral therapy (ART), and viral suppression in the Continuum of Care (CoC) will utilize common definitions including those by U.S. Department of Health and Human Services (DHHS) and Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB). Data will be collected in a large, simple trial design manner to provide all elements for both the primary and secondary outcomes.

調査の概要

状態

完了

条件

詳細な説明

This is an observational study involving retrospective and prospective medical record review covering a total maximum of 104 weeks (24 months) per subject. Behavioral data will be collected via ACASI at study entry to assess demographic and psychosocial variables of study subjects. All other data (biomedical, ART, healthcare utilization) at subsequent study visits will be collected via medical record abstraction. Information about missed visits as well as other healthcare utilization data can be abstracted from electronic appointment systems or other electronic systems at the clinical sites. Subject data will be abstracted from medical records for up to a maximum 26 weeks prior to the baseline study visit, as well as up to a maximum 78 weeks after the baseline study visit or through January 31, 2017, whichever occurs first, for a total maximum of 104 weeks or two years per subject. Data will also be collected from each Adolescent Medicine Trials Unit to assess clinic level variables at baseline (within 30 days of protocol registration) and 48 and 96 weeks after baseline. Definitions of engagement, prescription of antiretroviral therapy (ART), and viral suppression in the Continuum of Care (CoC) will utilize common definitions including those by U.S. Department of Health and Human Services (DHHS) and Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB). Data will be collected in a large, simple trial design manner to provide all elements for both the primary and secondary outcomes.

研究の種類

観察的

入学 (実際)

924

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

    • California
      • Aurora、California、アメリカ、80045
        • University of Colorado/The Children's Hospital
      • Los Angeles、California、アメリカ、90027
        • Children's Hopsital of Los Angeles
    • District of Columbia
      • Washington、District of Columbia、アメリカ、20010
        • Children's Hospital National Medical Center
    • Florida
      • Miami、Florida、アメリカ、33101
        • University of Miami School of Medicine
      • Tampa、Florida、アメリカ、33606
        • University of South Florida
    • Illinois
      • Chicago、Illinois、アメリカ、60612
        • Stroger Hospital of Cook County
    • Louisiana
      • New Orleans、Louisiana、アメリカ、70112
        • Tulane University Health Sciences Center
    • Maryland
      • Baltimore、Maryland、アメリカ、21287
        • Johns Hopkins University
    • Massachusetts
      • Boston、Massachusetts、アメリカ、02215
        • Fenway Institute
    • Michigan
      • Detroit、Michigan、アメリカ、48201
        • Children's Hospital of Michigan
    • New York
      • Bronx、New York、アメリカ、10467
        • Montefiore Medical Center
    • Pennsylvania
      • Philadelphia、Pennsylvania、アメリカ、19104
        • Children's Hospital of Philadelphia
    • Tennessee
      • Memphis、Tennessee、アメリカ、38105
        • St. Jude Children's Research Hospital
    • Texas
      • Houston、Texas、アメリカ、77030
        • Baylor College of Medicine/Texas Children's Hospital

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

13年~24年 (子、大人)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

サンプリング方法

非確率サンプル

調査対象母集団

  1. Behaviorally-infected, HIV-positive adolescents and young adults who are currently receiving or plan to receive their medical care at any clinical site that is part of the AMTU;
  2. Ages 13 through 24, inclusive, at the Baseline visit;
  3. Males and females;
  4. Ability to understand spoken English; and
  5. Ability for the AMTU staff to access the subject's medical records for a maximum of 78 weeks after enrollment or through February 2017, whichever occurs first.

説明

Inclusion Criteria:

  • Laboratory evidence of HIV-1 infection per Centers for Disease Control and Prevention (CDC) Surveillance Case Definition for HIV Infection, 2014 (Section 1.1) http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6303a1.htm;
  • Behaviorally-acquired HIV after age 9 years;
  • Age 13 through 24 years, inclusive, at the baseline visit (Enrollment);
  • Planning to receive HIV medical care at an AMTU or at any clinical site that is part of the AMTU for the duration of study follow-up

    • If transition to an adult health care provider must occur during the course of study participation, continued AMTU staff accessibility to medical and appointment records;

  • Ability for the AMTU staff to access medical and appointment records for a maximum of 78 weeks after enrollment or through February 2017, whichever occurs first;
  • Ability to understand spoken English;
  • Willing and able to provide signed informed consent or assent;

NOTE: If consent/assent is obtained > 4 weeks prior to the enrollment date, reaffirmation of consent must be obtained prior to starting the Baseline visit.

-Parent or Legal Guardian permission, if applicable; and

In addition to all the criteria listed above, to be considered eligible for enrollment after August 31, 2015, an individual must also meet the following criterion.

-Must be considered either: (a) newly engaged in HIV medical care defined as no previous initial comprehensive HIV medical care visit with consent occurring before, at the time of, or within four weeks following that initial comprehensive visit; or (b) newly re-engaged in HIV medical care defined as attending the last medical appointment more than 52 weeks ago.

*NOTE: The initial HIV medical care appointment is defined as a routine HIV medical appointment where the adolescent attends with a medical provider authorized to prescribe medication.

This HIV medical appointment must be a non-emergency, routine condition-focused exam AND one or more of the following:

  • CD4, VL lab draw and/or review of these lab results;
  • Discussion around HIV ART options;
  • Primary and/or secondary HIV prevention education and counseling; or
  • Diagnosis and treatment of complications of HIV, and of AIDS-defining conditions.

Exclusion Criteria:

  • Presence of serious psychiatric symptoms (e.g., active hallucinations, thought disorder) that would impair the individual's ability to provide true informed consent or participate in the baseline ACASI*;
  • Visibly distraught (e.g., suicidal, homicidal, exhibiting violent behavior) at the time of consent or the baseline ACASI*; or
  • Intoxicated or under the influence of alcohol or other substances at the time of consent or the baseline ACASI*

    • NOTE: If consent/assent is obtained prior to the enrollment date, assessment for these exclusion criteria must be performed again prior to administration of the baseline ACASI (Enrollment). If any are present, the subject cannot be enrolled; do not administer the ACASI. Reassessment of eligibility and enrollment may take place at a later date per the discretion of the treating clinician.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

この研究は何を測定していますか?

主要な結果の測定

結果測定
時間枠
The proportion of subjects engaged in care at Baseline, per subject year, as defined by the HRSA HAB measure
時間枠:Baseline
Baseline
The proportion of subjects engaged in care at Week 26, per subject year, as defined by the HRSA HAB measure
時間枠:Week 26
Week 26
The proportion of subjects engaged in care at Week 52, per subject year, as defined by the HRSA HAB measure
時間枠:Week 52
Week 52
The proportion of subjects engaged in care at Week 78, per subject year, as defined by the HRSA HAB measure
時間枠:Week 78
Week 78
The proportion of subjects engaged in care at Baseline, per subject year, as defined by the DHHS measure
時間枠:Baseline
Baseline
The proportion of subjects engaged in care at Week 26, per subject year, as defined by the DHHS measure
時間枠:Week 26
Week 26
The proportion of subjects engaged in care at Week 52, per subject year, as defined by the DHHS measure
時間枠:Week 52
Week 52
The proportion of subjects engaged in care at Week 78, per subject year, as defined by the DHHS measure
時間枠:Week 78
Week 78
The proportion of subjects prescribed antiretroviral therapy at Baseline per subject year
時間枠:Baseline
Baseline
The proportion of subjects prescribed antiretroviral therapy at Week 26 per subject year
時間枠:Week 26
Week 26
The proportion of subjects prescribed antiretroviral therapy at Week 52 per subject year
時間枠:Week 52
Week 52
The proportion of subjects prescribed antiretroviral therapy at Week 78 per subject year
時間枠:Week 78
Week 78
The proportion of subjects that have achieved viral suppression at Baseline per subject year
時間枠:Baseline
Baseline
The proportion of subjects that have achieved viral suppression at Week 26 per subject year
時間枠:Week 26
Week 26
The proportion of subjects that have achieved viral suppression at Week 52 per subject year
時間枠:Week 52
Week 52
The proportion of subjects that have achieved viral suppression at Week 78 per subject year
時間枠:Week 78
Week 78

二次結果の測定

結果測定
時間枠
The proportion of subjects with advanced HIV disease at time of first clinical visit defined as a CD4 count < 200 cells/mm3
時間枠:Baseline
Baseline
The incidence of STIs in the study population as an indicator of transmission risk at Baseline
時間枠:Baseline
Baseline
The incidence of STIs in the study population as an indicator of transmission risk at Week 26
時間枠:Week 26
Week 26
The incidence of STIs in the study population as an indicator of transmission risk at Week 52
時間枠:Week 52
Week 52
The incidence of STIs in the study population as an indicator of transmission risk at Week 78
時間枠:Week 78
Week 78
Number of subjects with mental health issues at Baseline
時間枠:Baseline
Baseline
Number of subjects engaging in substance use at Baseline
時間枠:Baseline
Baseline
Number of subjects engaging in sexual risk behaviors at Baseline
時間枠:Baseline
Baseline
ART adherence rate at Baseline
時間枠:Baseline
Baseline
Frequency of missed clinic visits at Baseline
時間枠:Baseline
Baseline
Frequency of missed clinic visits at Week 26
時間枠:Week 26
Week 26
Frequency of missed clinic visits at Week 52
時間枠:Week 52
Week 52
Frequency of missed clinic visits at Week 78
時間枠:Week 78
Week 78
Types of services available at each AMTU at Baseline
時間枠:Baseline
Baseline
Types of services available at each AMTU at 48 weeks after Baseline
時間枠:Week 48
Week 48
Types of services available at each AMTU at 96 weeks after Baseline
時間枠:Week 96
Week 96
Proportion of subjects notifying their sexual partners after learning their HIV status
時間枠:Baseline
Baseline
Timing of subjects notifying their partners after learning about their HIV status
時間枠:Baseline
Baseline
Proportion of subjects with whom partner notification was discussed
時間枠:Baseline
Baseline

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

捜査官

  • 主任研究者:Bret Rudy, MD、NYU Langone Health

出版物と役立つリンク

研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。

便利なリンク

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始

2015年3月1日

一次修了 (実際)

2016年2月1日

研究の完了 (実際)

2016年2月1日

試験登録日

最初に提出

2015年4月2日

QC基準を満たした最初の提出物

2015年5月5日

最初の投稿 (見積もり)

2015年5月8日

学習記録の更新

投稿された最後の更新 (実際)

2017年2月28日

QC基準を満たした最後の更新が送信されました

2017年2月27日

最終確認日

2016年3月1日

詳しくは

本研究に関する用語

キーワード

その他の研究ID番号

  • ATN 125

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。

HIVの臨床試験

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