NCT05769218

Brief Summary

The US opioid overdose epidemic has been accompanied by an increase in human immunodeficiency (HIV) among persons who inject drugs. HIV pre-exposure prophylaxis (PrEP) is an FDA approved medication taken daily orally by individuals who are HIV negative, but who are at increased risk for HIV. In order to obtain PrEP, a prescription is needed. Before being prescribed HIV PrEP, it is recommended by the Centers for Disease Control and Prevention (CDC) to obtain an HIV test first. Although home HIV self-test kits are recommended by the CDC and are locally available, uptake remains low. CHORUS+ (Comprehensive HIV, Hepatitis C, and Opioid Use Disorder Response to the Unaddressed Syndemic +) is a theory-based, peer-delivered, mobile phone-supported intervention focused on enhancing uptake and adherence to HIV PrEP (primary outcome), and continuation of MOUD (secondary outcome) among persons who inject opioids. At recruitment, the intervention will include HIV self-testing, rapid initiation of PrEP and MOUD, and 6-month peer recovery coaching (PRC) to support adherence to these medications. This research study seeks to determine the efficacy of a novel intervention to increase the uptake of evidence-based measures to prevent HIV and treat opioid use disorder. The efficacy of this multi-site, two-arm randomized control trial of CHORUS+ and usual care \[passive referral\]. This study is not testing the efficacy of PrEP or HIV home testing which is already known. In addition the investigators will determine the influence of HIV self-testing on PrEP uptake and adherence. In the CHORUS+/ intervention arm, there will be a baseline in-person session with the participant to encourage uptake of PrEP and MOUD using motivational interviewing (MI).

Trial Health

77
On Track

Trial Health Score

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

Enrollment
284

participants targeted

Target at P75+ for not_applicable

Timeline
26mo left

Started Dec 2024

Longer than P75 for not_applicable

Geographic Reach
1 country

2 active sites

Status
recruiting

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

Study Progress40%
Dec 2024Jun 2028

First Submitted

Initial submission to the registry

March 3, 2023

Completed
12 days until next milestone

First Posted

Study publicly available on registry

March 15, 2023

Completed
1.8 years until next milestone

Study Start

First participant enrolled

December 19, 2024

Completed
2.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 1, 2027

Expected
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

June 30, 2028

Last Updated

May 13, 2025

Status Verified

May 1, 2025

Enrollment Period

2.5 years

First QC Date

March 3, 2023

Last Update Submit

May 12, 2025

Conditions

Keywords

Medication for opioid use disorderHuman immunodeficiency (HIV)Pre-exposure prophylaxis (PrEP)Peer recovery coaching (PRC)Motivational interviewing (MI)HIV self testingPeople who inject opioids (PWIO)

Outcome Measures

Primary Outcomes (1)

  • Adherence to HIV PrEP at 6 months Adherence to HIV PrEP

    This outcome will be assessed by the proportion of individuals who have dried blood spot tenofovir-diphosphate (TFV-DP) blood level 700 fmol/punch or greater at 6 months post-enrollment.

    6 months

Secondary Outcomes (5)

  • Adherence to PrEP at 3 and 12 months

    3 months. 12 months

  • Receipt of medication for opioid use disorder (MOUD)

    3 months, 6 months, and 12 months

  • Test results for gonorrhea

    Baseline, 3 months, 6 months, and 12 months

  • Test results for chlamydia

    Baseline, 3 months, 6 months, and 12 months

  • Test results for syphilis

    Baseline, 3 months, 6 months, and 12 months

Study Arms (2)

CHORUS+

EXPERIMENTAL

The baseline questionnaire for participants in this arm will be followed by a 30-minute motivational interviewing (MI) session with the peer recovery coach (PRC), and will assess readiness for change and provide information about PrEP. The PRC will also assess readiness for MOUD, and this will be further explored during subsequent visits.

Behavioral: CHORUS+

Usual care- control

ACTIVE COMPARATOR

Participants in this arm will receive passive referral for care. there will be no PRC MI session and they will not be offered PrEP or MOUD.

Other: Standard of care

Interventions

CHORUS+BEHAVIORAL

The CHORUS+ intervention will include a baseline interview with a peer recovery coach to encourage uptake of HIV PrEP (pre-exposure prophylaxis) and medications for opioid use disorder (MOUD) through motivational interviewing (MI). Participants will also be offered HIV self-testing on the day of recruitment, HIV PrEP (if they are HIV negative) and MOUD. Participants will then receive peer coaching for 6 months to increase adherence to PrEP and or MOUD.

CHORUS+

Normal protocols for care of participants who inject opioids will be followed.

Usual care- control

Eligibility Criteria

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

You may qualify if:

  • Injected opioids within the past 6 months (by self-report)
  • Willingness to provide contact information for two family members or friends
  • Willingness to sign medical records release forms
  • Ability to speak English
  • Plans to reside in Boston area for the next 6 months

You may not qualify if:

  • Individuals with HIV (self report)
  • Express desire to harm themselves or others
  • Individuals who are pregnant at baseline
  • Individuals who are already enrolled in an interventional study

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Boston Medical Center Faster Paths Bridge Clinic

Boston, Massachusetts, 02118, United States

RECRUITING

Victory Programs Mobile Prevention Services Van and Navigation Center

Boston, Massachusetts, 02118, United States

RECRUITING

Related Publications (1)

  • Miller SE, Dukes KA, Damato-MacPherson C, Psaros C, Scott NA, Taylor JL, Muroff J, Winter MR, Skiba LE, Lugo H, Cruz R, Ruiz-Mercado G, Crawford ND, Mayer KH, Assoumou SA. Pre-exposure prophylaxis (PrEP) and medications for opioid use disorder for persons who inject drugs: the CHORUS + randomized controlled trial study protocol. Addict Sci Clin Pract. 2025 Dec 25;21(1):17. doi: 10.1186/s13722-025-00634-2.

MeSH Terms

Conditions

Opioid-Related Disorders

Interventions

chorus protein, ArabidopsisStandard of Care

Condition Hierarchy (Ancestors)

Narcotic-Related DisordersSubstance-Related DisordersChemically-Induced DisordersMental Disorders

Intervention Hierarchy (Ancestors)

Quality Indicators, Health CareQuality of Health CareHealth Services AdministrationHealth Care Quality, Access, and Evaluation

Study Officials

  • Sabrina A Assoumou, MD MPH

    Boston Medical Center, Infectious Diseases

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Sabrina A Assoumou, MD MPH

CONTACT

Study Design

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

Study Record Dates

First Submitted

March 3, 2023

First Posted

March 15, 2023

Study Start

December 19, 2024

Primary Completion (Estimated)

July 1, 2027

Study Completion (Estimated)

June 30, 2028

Last Updated

May 13, 2025

Record last verified: 2025-05

Data Sharing

IPD Sharing
Will not share

Locations