Development of a Predictive Model for Sexually Transmitted Infections in Individuals Using Pre-Exposure Prophylaxis for HIV in Spain

NCT06860945 | Recruiting

• 1 other identifier: STI_PrEP24
• Study Type: observational
• Target: 9,000
• Locations: 1 country
• Sites: 26

Brief Summary

Objective: To develop and validate a predictive model for acquiring sexually transmitted infections (STIs) in individuals using HIV pre-exposure prophylaxis (PrEP) within the national program providing this strategy. Methods: Ambispective cohort study, multicentric (23 Spanish hospitals). All PrEP users, with follow-up within the program, will be included. Entry into the program will be considered as the baseline visit. From there, patients are followed quarterly, following the national protocols for monitoring PrEP users in Spain. At each visit, diagnosis of different STIs (serum, pharyngeal swab, urethral or urine sample, rectal swab, endocervical/vaginal swab, ulcer) is performed. Primary outcome variable: development of an STI (Yes/No). The following STIs will be considered: syphilis, Neisseria gonorrhoeae (NG) infection, Chlamydia trachomatis (CT) infection, lymphogranuloma venereum (LGV), Mycoplasma genitalium (MG) infection, genital herpes, hepatitis A, hepatitis B, hepatitis C, HIV infection, and MPOX. Secondary outcome variable: number of diagnosed STIs. In order to determine factors associated with acquiring an STI, multivariate analyses will be conducted using logistic regression. The best models will be analyzed in the validation population. To compare the models, we will follow the Bayesian approach suggested by Benavoli et al.

Conditions

Sexually Transmitted Infections (STIs); HIV; PrEP

Keywords

STI; HIV; PrEP; modelling; machine learning; adherence; persistence

Outcome Measures

Primary Outcomes (1)

• STI predictive model

  Predictive model for the acquisition of sexually transmitted infections in individuals using PrEP within the national provision program for this strategy

  through study completion, an average of 5 years

Secondary Outcomes (11)

• STI incidence

  through study completion, an average of 5 years

• STI dynamics

  through study completion, an average of 5 years

• asymptomatic STIs

  through study completion, an average of 5 years

• behavioral changes

  through study completion, an average of 5 years

• DOXYPEP

  through study completion, an average of 5 years

Study Arms (1)

STI_PrEPare

All individuals with documented initiation of daily oral PrEP, who have collected the medication at least once and have taken at least one pill, will be included in the study. The approved criteria for the use of oral PrEP in Spain, as recommended by the Spanish Gesida guidelines (GeSIDA. Recomendaciones sobre la Profilaxis Pre-Exposición para la Prevención de la Infección por VIH en España. Marzo 2023. Disponible en http://.gesida-seimc.org/category/guias-clinicas/otras-guias-vigentes/), are as follows: * People without HIV infection at the time of cohort inclusion * Age ≥ 16 yr who meet the following criteria: * MSM and transgender women with at least two of the following criteria during the last year: \> 10 sexual partners; Condomless anal sex; Chemsex; PEP; ≥ 1 STI * Sex worker women who report non-habitual use of condoms. * Cisgender males/females, who report condomless and present at least two of the same criteria as MSM and transgender.

Other: No Intervention: Observational Cohort

Interventions

No Intervention: Observational Cohort OTHER

No Intervention: Observational Cohort

STI_PrEPare

Eligibility Criteria

• Age: 16 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All individuals who meet the criteria for PrEP use in Spain, are over 16 years old, and have taken at least one pill.

You may qualify if:

• All individuals with documented initiation of oral PrEP (daily or event-driven regimens), who have collected the medication at least once and have taken at least one pill, will be included in the study.
• The approved criteria for the use of oral PrEP in Spain, as recommended by the Spanish Gesida guidelines (GeSIDA. Recomendaciones sobre la Profilaxis Pre-Exposición para la Prevención de la Infección por VIH en España. Marzo 2023. Available at http://.gesida-seimc.org/category/guias-clinicas/otras-guias-vigentes/), are as follows:
• Age ≥ 16 yr who meet the following criteria:
• MSM and transgender women with at least two of the following criteria during the last year: \> 10 sexual partners; Condomless anal sex; Chemsex; PEP; ≥ 1 STI
• Sex worker women who report non-habitual use of condoms.
• Cisgender males/females, who report condomless and present at least two of the same criteria as MSM and transgender.
• PWID with unsafe injection practices

Sponsors & Collaborators

• Hospital Universitario de Valme: lead
• Instituto de Salud Carlos III: collaborator

Study Sites (26)

Hospital Universitario de Torrecárdenas

Almería, Spain

RECRUITING

Hospital Universitario Puerto Real

Cadiz, Spain

RECRUITING

Hospital Universitario Santa Lucía

Cartagena, Spain

RECRUITING

hospital Universitario reina Sofía

Córdoba, Spain

RECRUITING

Hospital Virgen de la Luz

Cuenca, Spain

RECRUITING

Hospital Universitario de Elche

Elche, Spain

RECRUITING

Hospital Clínico Universitario San Cecilio

Granada, Spain

RECRUITING

Hospital Universitario Virgen de las Nieves

Granada, Spain

RECRUITING

Hospital Universitario Juan Ramón Jiménez

Huelva, Spain

RECRUITING

Complejo Hospitalario de Jaén

Jaén, Spain

RECRUITING

Hospital de Jerez de la Frontera

Jerez de la Frontera, Spain

RECRUITING

Hospital Universitario de Bellvitge

L'Hospitalet de Llobregat, Spain

RECRUITING

Hospital Universitario Dr. Negrín

Las Palmas de Gran Canaria, Spain

RECRUITING

Centro Sanitario Sandoval

Madrid, Spain

RECRUITING

Hospital Fundación Jiménez Díaz

Madrid, Spain

RECRUITING

Hospital Universitario Infanta Leonor

Madrid, Spain

RECRUITING

Hospital Universitario La Princesa

Madrid, Spain

RECRUITING

Hospital Regional Universitario de Málaga

Málaga, Spain

RECRUITING

Hospital Universitario Virgen de la Victoria

Málaga, Spain

RECRUITING

Hospital Universitario Virgen de la Arrixaca

Murcia, Spain

RECRUITING

Hospital Universitario Marqués de Valdecilla

Santander, Spain

RECRUITING

Hospital Universitario Virgen de la Macarena

Seville, Spain

RECRUITING

Hospital Universitario Virgen de Valme

Seville, Spain

RECRUITING

Hospital Universitario Virgen del Rocío

Seville, Spain

RECRUITING

Hospital Universitario de Valladolid

Valladolid, Spain

RECRUITING

Hospital Universitario Álvaro Cunqueiro

Vigo, Spain

RECRUITING

Related Publications (13)

• Jongen VW, Zimmermann HML, Goedhart M, Bogaards JA, Davidovich U, Coyer L, de Vries HJC, Prins M, Hoornenborg E, Schim van der Loeff MF; Amsterdam PrEP Project team in the HIV Transmission Elimination Amsterdam (H-TEAM) Initiative. Can we screen less frequently for STI among PrEP users? Assessing the effect of biannual STI screening on timing of diagnosis and transmission risk in the AMPrEP Study. Sex Transm Infect. 2023 May;99(3):149-155. doi: 10.1136/sextrans-2022-055439. Epub 2022 May 18.

  PMID: 35584898 BACKGROUND

• Tang EC, Vittinghoff E, Philip SS, Doblecki-Lewis S, Bacon O, Chege W, Coleman ME, Elion R, Buchbinder S, Kolber MA, Liu AY, Cohen SE. Quarterly screening optimizes detection of sexually transmitted infections when prescribing HIV preexposure prophylaxis. AIDS. 2020 Jul 1;34(8):1181-1186. doi: 10.1097/QAD.0000000000002522.

  PMID: 32205724 BACKGROUND

• van Wifferen F, Hoornenborg E, Schim van der Loeff MF, Heijne J, van Hoek AJ. Cost-effectiveness of two screening strategies for Chlamydia trachomatis and Neisseria gonorrhoeae as part of the PrEP programme in the Netherlands: a modelling study. Sex Transm Infect. 2021 Dec;97(8):607-612. doi: 10.1136/sextrans-2020-054741. Epub 2021 Jan 11.

  PMID: 33431605 BACKGROUND

• McManus H, Grulich AE, Amin J, Selvey C, Vickers T, Bavinton B, Zablotska I, Vaccher S, Jin F, Holden J, Price K, Yeung B, Cabrera Quichua G, Ogilvie E, McNulty A, Smith D, Guy R. Comparison of Trends in Rates of Sexually Transmitted Infections Before vs After Initiation of HIV Preexposure Prophylaxis Among Men Who Have Sex With Men. JAMA Netw Open. 2020 Dec 1;3(12):e2030806. doi: 10.1001/jamanetworkopen.2020.30806.

  PMID: 33355675 BACKGROUND

• Traeger MW, Schroeder SE, Wright EJ, Hellard ME, Cornelisse VJ, Doyle JS, Stoove MA. Effects of Pre-exposure Prophylaxis for the Prevention of Human Immunodeficiency Virus Infection on Sexual Risk Behavior in Men Who Have Sex With Men: A Systematic Review and Meta-analysis. Clin Infect Dis. 2018 Aug 16;67(5):676-686. doi: 10.1093/cid/ciy182.

  PMID: 29509889 BACKGROUND

• Ayerdi O, Orviz E, Valls Carbo A, Fernandez Pineiro N, Vera Garcia M, Puerta Lopez T, Ballesteros Martin J, Rodriguez Martin C, Baza Caraciolo B, Lejarraga Canas C, Perez-Garcia JA, Carrio D, Garcia Lotero M, Ferreras Forcada M, Gonzalez Polo M, Raposo Utrilla M, Delgado-Iribarren A, Del Romero-Guerrero J, Estrada Perez V. Incidence of sexually transmitted infections and screening models among pre-exposure prophylaxis users. Enferm Infecc Microbiol Clin (Engl Ed). 2024 Dec;42(10):570-576. doi: 10.1016/j.eimce.2024.03.004. Epub 2024 Mar 16.

  PMID: 38492988 BACKGROUND

• Traeger MW, Guy R, Asselin J, Patel P, Carter A, Wright EJ, Grulich A, McManus H, Fairley CK, Chow EPF, McNulty A, Finlayson R, Bell C, Owen L, Marshall L, Russell D, O'Donnell D, Donovan B, Hellard ME, Stoove MA; Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of Sexually Transmissible Infections and Blood Borne Viruses (ACCESS) Study Group. Real-world trends in incidence of bacterial sexually transmissible infections among gay and bisexual men using HIV pre-exposure prophylaxis (PrEP) in Australia following nationwide PrEP implementation: an analysis of sentinel surveillance data. Lancet Infect Dis. 2022 Aug;22(8):1231-1241. doi: 10.1016/S1473-3099(22)00175-X. Epub 2022 May 25.

  PMID: 35643090 BACKGROUND

• Traeger MW, Cornelisse VJ, Asselin J, Price B, Roth NJ, Willcox J, Tee BK, Fairley CK, Chang CC, Armishaw J, Vujovic O, Penn M, Cundill P, Forgan-Smith G, Gall J, Pickett C, Lal L, Mak A, Spelman TD, Nguyen L, Murphy DA, Ryan KE, El-Hayek C, West M, Ruth S, Batrouney C, Lockwood JT, Hoy JF, Hellard ME, Stoove MA, Wright EJ; PrEPX Study Team. Association of HIV Preexposure Prophylaxis With Incidence of Sexually Transmitted Infections Among Individuals at High Risk of HIV Infection. JAMA. 2019 Apr 9;321(14):1380-1390. doi: 10.1001/jama.2019.2947.

  PMID: 30964528 BACKGROUND

• Hoornenborg E, Coyer L, Achterbergh RCA, Matser A, Schim van der Loeff MF, Boyd A, van Duijnhoven YTHP, Bruisten S, Oostvogel P, Davidovich U, Hogewoning A, Prins M, de Vries HJC; Amsterdam PrEP Project team in the HIV Transmission Elimination AMsterdam (H-TEAM) Initiative. Sexual behaviour and incidence of HIV and sexually transmitted infections among men who have sex with men using daily and event-driven pre-exposure prophylaxis in AMPrEP: 2 year results from a demonstration study. Lancet HIV. 2019 Jul;6(7):e447-e455. doi: 10.1016/S2352-3018(19)30136-5. Epub 2019 Jun 6.

  PMID: 31178284 BACKGROUND

• Drak D, Mcmanus H, Vickers T, Heron JE, Vaccher S, Zablotska I, Guy R, Bavinton B, Jin F, Grulich AE, Bloch M, O'Connor CC, Gracey DM; Expanded PrEP Implementation in Communities New South Wales (EPIC-NSW) research group. Renal impairment in a large-scale HIV preexposure prophylaxis implementation cohort. AIDS. 2021 Nov 15;35(14):2319-2326. doi: 10.1097/QAD.0000000000003035.

  PMID: 34310371 BACKGROUND

• Baeten JM, Donnell D, Ndase P, Mugo NR, Campbell JD, Wangisi J, Tappero JW, Bukusi EA, Cohen CR, Katabira E, Ronald A, Tumwesigye E, Were E, Fife KH, Kiarie J, Farquhar C, John-Stewart G, Kakia A, Odoyo J, Mucunguzi A, Nakku-Joloba E, Twesigye R, Ngure K, Apaka C, Tamooh H, Gabona F, Mujugira A, Panteleeff D, Thomas KK, Kidoguchi L, Krows M, Revall J, Morrison S, Haugen H, Emmanuel-Ogier M, Ondrejcek L, Coombs RW, Frenkel L, Hendrix C, Bumpus NN, Bangsberg D, Haberer JE, Stevens WS, Lingappa JR, Celum C; Partners PrEP Study Team. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012 Aug 2;367(5):399-410. doi: 10.1056/NEJMoa1108524. Epub 2012 Jul 11.

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• Grant RM, Anderson PL, McMahan V, Liu A, Amico KR, Mehrotra M, Hosek S, Mosquera C, Casapia M, Montoya O, Buchbinder S, Veloso VG, Mayer K, Chariyalertsak S, Bekker LG, Kallas EG, Schechter M, Guanira J, Bushman L, Burns DN, Rooney JF, Glidden DV; iPrEx study team. Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study. Lancet Infect Dis. 2014 Sep;14(9):820-9. doi: 10.1016/S1473-3099(14)70847-3. Epub 2014 Jul 22.

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MeSH Terms

Conditions

Sexually Transmitted Diseases

Condition Hierarchy (Ancestors)

Communicable Diseases; Infections; Genital Diseases; Urogenital Diseases; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Anaïs Corma-Gómez, MD, PhD

  Hospital Clínico Universitario de Valencia

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Anaïs Corma-Gómez

CONTACT

+34676170692; anais.corgo@gmail.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: OTHER
• Target Duration: 5 Years
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Medical Doctor, PhD

Study Record Dates

• First Submitted: February 18, 2025
• First Posted: March 6, 2025
• Study Start: January 1, 2025
• Primary Completion: June 30, 2025
• Study Completion: January 1, 2026
• Last Updated: March 6, 2025

Record last verified: 2025-02

Locations

ES (26)