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PRe-Exposure Prophylaxis Acceptability & Readiness Assessments for Toronto gaY, Bisexual and Other Men Who Have Sex With Men-5 (PREP-5)
A Pilot Study of Daily TDF/FTC-based PrEP Among High-risk Toronto MSM:The PREPARATORY-5 Study
Canada continues to see an unrelenting stream of new HIV diagnoses, with a disproportionate burden among gay, bisexual, and other MSM in major centers such as Toronto. Pre-exposure prophylaxis (PrEP) with oral, daily tenofovir/emtricitabine (TDF/FTC, Truvada®) is a novel biomedical approach to HIV prevention shown in the iPrEx trial to be safe and efficacious in reducing HIV acquisition by 44% among MSM, when provided in a comprehensive package of HIV prevention interventions including counseling, testing/treatment of sexually transmitted infections (STIs), and condoms. There is now widespread mobilization to assess the feasibility of PrEP roll-out worldwide, with urgent calls for 'demonstration projects' addressing real-world PrEP implementation issues.
PREPARATORY-5 is Canada's first PrEP demonstration project, and will examine real-world PrEP implementation issues including acceptability, effectiveness, impact on sexually transmitted infections, and strategies for supporting adherence outside the clinical trial setting. The investigators have also established a comprehensive community-based research program investigating the role of community-based organizations in PrEP implementation and delivery.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Studietype
Inschrijving (Werkelijk)
Fase
- Fase 4
Contacten en locaties
Studie Locaties
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Ontario
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Toronto, Ontario, Canada, M5B 1W8
- St. Michael's Hospital
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Self-identified man who has sex with men
- Age 18 years or older
- Able to communicate in both written and oral english
- HIRI-MSM score greater than or equal to 10
- At least one self-reported unprotected receptive anal sex act over the preceding 6 months
- Creatinine clearance greater than or equal to 60mL/min by Modified Diet in Renal Disease (MDRD) formula
- HIV un-infected at screening using standard ELISA and Western Blot testing
Exclusion Criteria:
- Clinical signs or symptoms suggestive of an HIV seroconversion illness within the last 3 months in the opinion of the investigator
- Use of pre- or post-exposure prophylaxis within the last 3 months
- Use of concomitant nephrotoxic drugs
- Use of concomitant immune modulatory drugs
- Hepatitis B surface antigen positivity
- Any condition or concomitant medication portending an increased risk of osteoporosis
- Enrollment in any other HIV prevention program or trial
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Preventie
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
---|---|
Experimenteel: Tenofovir/emtricitabine
MSM receiving once daily TDF/FTC-based (Truvada®) pre-exposure prophylaxis
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Once daily Tenofovir/emtricitabine (Truvada®)
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
---|---|---|
Participants' self-reported overall acceptability of PrEP
Tijdsspanne: 12 months
|
Participants' self-reported overall acceptability of PrEP over the full one-year follow-up period (including the use of the medication, clinic visits, and their impact on the participant's life) will be quantified using a Likert scale.
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12 months
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The level of community interest in PrEP
Tijdsspanne: 12 months
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The level of community interest in PrEP will be measured by quantifying the volume, rate and HIV risk levels of patient referrals to the PrEP clinic from each key referral source
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12 months
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
---|---|---|
Adherence to daily TDF/FTC-based PrEP
Tijdsspanne: 12 months
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Adherence will be measured by self-report, pill count, and intra-RBC tenofovir diphosphate levels.
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12 months
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Time required by the patient, physician and research coordinator for each type of study visit.
Tijdsspanne: 12 months
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The time required by the patient, physician and research coordinator will be measured for each type of study visit.
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12 months
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HIV infection
Tijdsspanne: 12 months
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HIV infection will be detected using point-of-care tests, standard serology and HIV RNA testing.
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12 months
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Sexually transmitted infections
Tijdsspanne: 12 months
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Testing will be performed at each study visit to screen for gonorrhea, chlamydia and syphilis infection, including pharyngeal swab cultures, rectal swab cultures and urine NAAT tests.
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12 months
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Burden of syndemic health problems
Tijdsspanne: 12 months
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The burden of specific syndemic health problems (depression, social anxiety, substance abuse, sexual addiction, childhood sexual abuse, partner violence) will be quantified using standardized, validated psychometric tools.
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12 months
|
Change in estimated glomerular filtration rate
Tijdsspanne: 12 months
|
Estimated by the Modified Diet in Renal Disease (MDRD) formula
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12 months
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Percentage change in bone mineral density at the lumbar spine and total hip
Tijdsspanne: 12 months
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12 months
|
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Adverse events
Tijdsspanne: 12 months
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Adverse events will be assessed at each visit via clinical assessment and laboratory monitoring (CBC, phosphate, urinalysis).
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12 months
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Pilot testing study instruments
Tijdsspanne: 12 months
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Outcomes related to pilot testing study instruments will include numbers of minutes required and participant-reported acceptability for each procedure
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12 months
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Medewerkers en onderzoekers
Publicaties en nuttige links
Algemene publicaties
- Tan DHS, Schnubb A, Lawless J, Szadkowski L, Grennan T, Wilton J, Fowler S, Hart TA, Maxwell J, Raboud JM. Acceptability and tolerability of and adherence to HIV preexposure prophylaxis among Toronto gay and bisexual men: a pilot study. CMAJ Open. 2018 Dec 10;6(4):E611-E617. doi: 10.9778/cmajo.20180068. Print 2018 Oct-Dec.
- Wilton J, Noor SW, Schnubb A, Lawless J, Hart TA, Grennan T, Fowler S, Maxwell J, Tan DHS. High HIV risk and syndemic burden regardless of referral source among MSM screening for a PrEP demonstration project in Toronto, Canada. BMC Public Health. 2018 Feb 27;18(1):292. doi: 10.1186/s12889-018-5180-8.
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Schatting)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- RNA-virusinfecties
- Virusziekten
- Infecties
- Door bloed overgedragen infecties
- Overdraagbare ziekten
- Seksueel overdraagbare aandoeningen, viraal
- Seksueel overdraagbare aandoeningen
- Lentivirus-infecties
- Retroviridae-infecties
- Ziekten van het immuunsysteem
- Langzame virusziekten
- HIV-infecties
- Verworven Immunodeficiëntie Syndroom
- Immunologische deficiëntie syndromen
- Moleculaire mechanismen van farmacologische werking
- Anti-infectieuze middelen
- Antivirale middelen
- Reverse Transcriptase-remmers
- Nucleïnezuursyntheseremmers
- Enzymremmers
- Anti-hiv-middelen
- Antiretrovirale middelen
- Tenofovir
- Emtricitabine
Andere studie-ID-nummers
- PREPARATORY-5
Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .
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