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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)

3. november 2026 oppdatert av: Cherie Blair, MD, PhD, University of California, Los Angeles

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

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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.

Studietype

Intervensjonell

Registrering (Antatt)

300

Fase

  • Fase 4

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

    • California
      • Los Angeles, California, Forente stater, 90038
        • UCLA Vine Street Clinic
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Mann

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Forebygging
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 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)

Eksperimentell: 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

Eksperimentell: 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

Hva måler studien?

Primære resultatmål

Resultatmål
Tidsramme
Quarterly incidence of chlamydia, gonorrhea, and/or early syphilis infection
Tidsramme: 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)

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Samarbeidspartnere

Etterforskere

  • Hovedetterforsker: Cherie Blair, MD, PhD, University of California, Los Angeles

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. november 2026

Primær fullføring (Antatt)

30. juni 2030

Studiet fullført (Antatt)

30. juni 2031

Datoer for studieregistrering

Først innsendt

3. november 2026

Først innsendt som oppfylte QC-kriteriene

3. november 2026

Først lagt ut (Faktiske)

9. november 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

9. november 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

3. november 2026

Sist bekreftet

1. november 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Andre studie-ID-numre

  • 26-1595
  • 1R01DA066392-01A1 (U.S. NIH-stipend/kontrakt)

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

JA

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Ja

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

produkt produsert i og eksportert fra USA

Nei

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