NCT03869671

Brief Summary

People who inject drugs (PWID) experience high risk of HIV acquisition. Antiretroviral pre-exposure prophylaxis (PrEP) is an efficacious biomedical HIV prevention strategy for high risk HIV-uninfected individuals including PWID, yet uptake has been low in this population and uptake and adherence interventions have not been developed or tested. Drawing from formative qualitative research, the overall goal of this project is to develop an intervention to promote PrEP uptake and adherence among PWID in the U.S. Northeast. The investigators will:

  • Analyze existing literature and data to identify specific barriers and facilitators to PrEP uptake and adherence among PWID to inform the initial adaptation of existing theory-based interventions;
  • Conduct qualitative interviews with \~30 PWID and \~10 key informants (PrEP and other clinical and social service providers) to identify intervention targets;
  • Develop and iteratively refine and finalize an intervention manual based on feedback from qualitative exit-interviews with an interventionist and \~10 PWID; and
  • Conduct a pilot randomized clinical trial (RCT) in \~50 HIV-uninfected PWID to compare PrEP uptake and adherence outcomes and assess intervention feasibility and acceptability.

Trial Health

15
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Timeline
Completed

Started Mar 2021

Status
withdrawn

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 8, 2019

Completed
3 days until next milestone

First Posted

Study publicly available on registry

March 11, 2019

Completed
2 years until next milestone

Study Start

First participant enrolled

March 1, 2021

Completed
1 year until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2022

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2022

Completed
Last Updated

March 10, 2021

Status Verified

March 1, 2021

Enrollment Period

1 year

First QC Date

March 8, 2019

Last Update Submit

March 8, 2021

Conditions

Keywords

Antiretroviral pre-exposure prophylaxis (PrEP)Syringe exchange program (SEP)HIV-related risk behaviorsAdherence interventionPeople who inject drugs (PWID)

Outcome Measures

Primary Outcomes (8)

  • PrEP uptake by self-report

    measured using 1 item in a structured questionnaire

    1 month

  • PrEP uptake by self-report

    measured using 1 item in a structured questionnaire

    3 months

  • PrEP uptake by pharmacy records

    measured by accessing pharmacy records

    1 month

  • PrEP uptake by pharmacy records

    measured by accessing pharmacy records

    3 months

  • PrEP adherence by self-report

    measured using 1 item in a structured questionnaire to determine the proportion of doses taken as prescribed

    1 month

  • PrEP adherence by self-report

    measured using 1 item in a structured questionnaire to determine the proportion of doses taken as prescribed

    3 months

  • PrEP adherence by dried blood spot

    measured via detection of tenofovir and emtricitabine in dried blood spots (DBS)

    1 month

  • PrEP adherence by dried blood spot

    measured via detection of tenofovir and emtricitabine in dried blood spots (DBS)

    3 months

Secondary Outcomes (6)

  • Participant satisfaction with intervention content

    1 month

  • Participant satisfaction with intervention delivery methods

    1 month

  • Interventionist satisfaction with training materials

    1 month

  • Interventionist satisfaction with intervention manual

    1 month

  • Interventionist satisfaction with intervention content

    1 month

  • +1 more secondary outcomes

Study Arms (2)

PrEP uptake/adherence intervention

EXPERIMENTAL

A trained interventionist will deliver the manualized, single session PrEP uptake/adherence intervention in private counseling rooms at a community-based setting.

Behavioral: PrEP uptake/adherence intervention

Harm reduction standard of care

ACTIVE COMPARATOR

Participants will be provided harm reduction supplies and health information and counseling according to routine practice at the community-based setting.

Behavioral: Harm reduction standard of care

Interventions

The interventionist will follow the manual to deliver informational and motivational strategies to participants to enhance their PrEP uptake (including completing clinical screening and obtaining/filling a PrEP prescription) and adherence (taking daily oral PrEP doses). The interventionist will assist participants in problem-solving around topics including limited transportation options, identifying local pharmacies, storing medications given complex living arrangements, coping with side effects, communicating with providers and pharmacists, and maintaining daily medication schedules with reminders and cues.

PrEP uptake/adherence intervention

Participants will be provided with harm reduction supplies and health information and counseling according to routine practice at the community-based setting (harm reduction organization).

Harm reduction standard of care

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • An adult PWID
  • Self report of any high risk behaviors for HIV (past-month receptive syringe sharing, transactional sex, condomless sex with an HIV-infected or unknown status partner)

You may not qualify if:

  • Unable or unwilling to provide informed consent
  • For Phase 3 (the RCT pilot):
  • Clinically eligible for PrEP (confirmed HIV-uninfected status, adequate renal function \[estimated creatinine clearance ≥60 ml/min\], and documented hepatitis B virus \[HBV\] status)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Conditions

Substance Abuse, IntravenousAdherence Interventions

Condition Hierarchy (Ancestors)

Substance-Related DisordersChemically-Induced DisordersMental DisordersMedication AdherencePatient CompliancePatient Acceptance of Health CareTreatment Adherence and ComplianceHealth BehaviorBehavior

Study Officials

  • Angela Bazzi, PhD, MPH

    Boston University

    PRINCIPAL INVESTIGATOR
0

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 8, 2019

First Posted

March 11, 2019

Study Start

March 1, 2021

Primary Completion

March 1, 2022

Study Completion

March 1, 2022

Last Updated

March 10, 2021

Record last verified: 2021-03

Data Sharing

IPD Sharing
Will not share