- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT02149888
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.
Studieöversikt
Status
Betingelser
Intervention / Behandling
Studietyp
Inskrivning (Faktisk)
Fas
- Fas 4
Kontakter och platser
Studieorter
-
-
Ontario
-
Toronto, Ontario, Kanada, M5B 1W8
- St. Michael's Hospital
-
-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
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
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Förebyggande
- Tilldelning: N/A
- Interventionsmodell: Enskild gruppuppgift
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
---|---|
Experimentell: Tenofovir/emtricitabine
MSM receiving once daily TDF/FTC-based (Truvada®) pre-exposure prophylaxis
|
Once daily Tenofovir/emtricitabine (Truvada®)
Andra namn:
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
---|---|---|
Participants' self-reported overall acceptability of PrEP
Tidsram: 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.
|
12 months
|
The level of community interest in PrEP
Tidsram: 12 months
|
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
|
12 months
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
---|---|---|
Adherence to daily TDF/FTC-based PrEP
Tidsram: 12 months
|
Adherence will be measured by self-report, pill count, and intra-RBC tenofovir diphosphate levels.
|
12 months
|
Time required by the patient, physician and research coordinator for each type of study visit.
Tidsram: 12 months
|
The time required by the patient, physician and research coordinator will be measured for each type of study visit.
|
12 months
|
HIV infection
Tidsram: 12 months
|
HIV infection will be detected using point-of-care tests, standard serology and HIV RNA testing.
|
12 months
|
Sexually transmitted infections
Tidsram: 12 months
|
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.
|
12 months
|
Burden of syndemic health problems
Tidsram: 12 months
|
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.
|
12 months
|
Change in estimated glomerular filtration rate
Tidsram: 12 months
|
Estimated by the Modified Diet in Renal Disease (MDRD) formula
|
12 months
|
Percentage change in bone mineral density at the lumbar spine and total hip
Tidsram: 12 months
|
12 months
|
|
Adverse events
Tidsram: 12 months
|
Adverse events will be assessed at each visit via clinical assessment and laboratory monitoring (CBC, phosphate, urinalysis).
|
12 months
|
Pilot testing study instruments
Tidsram: 12 months
|
Outcomes related to pilot testing study instruments will include numbers of minutes required and participant-reported acceptability for each procedure
|
12 months
|
Samarbetspartners och utredare
Publikationer och användbara länkar
Allmänna publikationer
- 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.
Studieavstämningsdatum
Studera stora datum
Studiestart
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Uppdateringar av studier
Senaste uppdatering publicerad (Uppskatta)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
- RNA-virusinfektioner
- Virussjukdomar
- Infektioner
- Blodburna infektioner
- Smittsamma sjukdomar
- Sexuellt överförbara sjukdomar, virala
- Sexuellt överförbara sjukdomar
- Lentivirusinfektioner
- Retroviridae-infektioner
- Immunsystemets sjukdomar
- Långsamma virussjukdomar
- HIV-infektioner
- Förvärvat immunbristsyndrom
- Immunologiska bristsyndrom
- Molekylära mekanismer för farmakologisk verkan
- Anti-infektionsmedel
- Antivirala medel
- Omvända transkriptashämmare
- Nukleinsyrasynteshämmare
- Enzyminhibitorer
- Anti-HIV-medel
- Antiretrovirala medel
- Tenofovir
- Emtricitabin
Andra studie-ID-nummer
- PREPARATORY-5
Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .
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