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Assessment of Pre-Exposure Prophylaxis (PrEP) Administered at Sexually Transmitted Disease (STD) Clinics

Primary Purpose

HIV Infections

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
FTC 200 mg/TDF 300 mg fixed-dose combination tablet
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for HIV Infections

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)MaleAccepts Healthy Volunteers

Inclusion Criteria:

  • Must be either a man who has sex with men or a transgender female
  • Male sex (at birth)
  • Willing and able to provide written informed consent
  • HIV-1 uninfected, defined as having a negative rapid HIV antibody test at both screening visit and enrollment and a negative 4th generation antibody/antigen test at screening
  • No laboratory evidence of a detectable HIV viral load (San Francisco site only)
  • Evidence of risk of acquiring HIV-1 infection including any one of the following:

    (1) Condomless anal sex with two or more male or transgender female sex partners during the last 12 months; or (2) two or more episodes of anal sex with at least one HIV-positive partner during the last 12 months; or (3) sex with a male or transgender female partner and any of the following STDs diagnosed during the last 12 months or at screening: syphilis, rectal gonorrhea, or rectal chlamydia.

  • Able to provide a street address of residence or phone number for themselves or two personal contacts who would know their whereabouts during the period of the demonstration project
  • Adequate renal function: creatinine clearance of 60 ml/min or greater as estimated by the Cockcroft-Gault equation within 45 days of enrollment
  • A urine dipstick with a negative or trace result for protein within 45 days of enrollment
  • Fluent in English or in Spanish

Exclusion Criteria:

  • Signs or symptoms of acute HIV infection
  • Previously diagnosed active and serious infections including active tuberculosis infection or osteomyelitis and all infections requiring parenteral antibiotic therapy (other than STDs requiring intramuscular injections of antibiotics); active clinically significant medical problems including poorly controlled cardiac disease (e.g., symptoms of ischemia or congestive heart failure) or previously diagnosed malignancy expected to require further treatment
  • Hepatitis B surface antigen (HBsAg) positive
  • History of pathological bone fractures not related to trauma
  • Receiving ongoing therapy with any of the following: investigational antiretroviral agents (PEP is allowed as described in the protocol), interferon (alpha, beta, or gamma) or interleukin (e.g., IL-2) therapy, agents with significant nephrotoxic potential, other agents that may inhibit or compete for elimination via active renal tubular secretion (e.g., probenecid), and/or other investigational agents
  • Concomitant participation in a clinical trial using investigational agents, including placebo-controlled clinical trials using such agents
  • At enrollment, has any other condition that, based on the opinion of the investigator or designee, would preclude provision of informed consent; make participation in the project unsafe; complicate interpretation of outcome data; or otherwise interfere with achieving the project objectives

Sites / Locations

  • SF City Clinic Non-Network CRS
  • Whitman Walker Non-network CRS
  • Miami PrEP Non-Network CRS

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Emtricitabine (FTC)/tenofovir disoproxil fumarate (TDF)

Arm Description

All study participants will be assigned to this arm and will receive one FTC/TDF tablet orally once a day.

Outcomes

Primary Outcome Measures

Measurement of Acceptance Rate of PrEP
Measurement of Refusal Rate of PrEP
Duration of PrEP Use
Number of study drug interruptions
Duration of PrEP Use
Mean duration of interruptions
Measurement of Side Effects/Toxicities
Measurement of PrEP Adherence by TFV-DP Levels in DBS
Number of Male Sexual Partners
Measurement of PrEP Adherence by Medication Possession Ratio
Medication possession ratio is defined as the number of dispensed pills divided by the number of days between visits

Secondary Outcome Measures

Number of Participants Who Seroconvert
Measurement of HIV Drug Resistance Patterns Among Participants Who Become Infected

Full Information

First Posted
June 29, 2012
Last Updated
November 3, 2021
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT01632995
Brief Title
Assessment of Pre-Exposure Prophylaxis (PrEP) Administered at Sexually Transmitted Disease (STD) Clinics
Official Title
Implementation of HIV Pre-exposure Prophylaxis (PrEP): A Demonstration Project
Study Type
Interventional

2. Study Status

Record Verification Date
July 2016
Overall Recruitment Status
Completed
Study Start Date
October 2012 (undefined)
Primary Completion Date
February 2015 (Actual)
Study Completion Date
February 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

5. Study Description

Brief Summary
This study will assess the uptake, acceptability, safety, and feasibility of HIV pre-exposure prophylaxis (PrEP), consisting of a once-daily fixed-dose combination tablet of emtricitabine (FTC)/tenofovir disoproxil fumarate (TDF), administered at sexually transmitted disease (STD) clinics and a community health center in the United States.
Detailed Description
A previous study (iPrEx) showed that daily PrEP with FTC/TDF provided with a comprehensive package of prevention services is effective in preventing HIV infection among men who have sex with men (MSM). The PrEP administered in that study was given in the context of a research setting/controlled trial, but it is important to evaluate the acceptability, sustainability, and safety of PrEP in a "real world" setting. This study will evaluate PrEP administered to HIV-uninfected MSM and transgender females at two STD clinics and one community health center in the United States. Each participant will receive PrEP for up to 1 year and will have up to 8 study visits. PrEP will consist of one fixed-dose FTC/TDF combination tablet orally each day. All participants will have study visits at screening, enrollment, and 4 weeks after enrollment; participants will continue to have visits at Weeks 12, 24, 36, 48, and 52 if they do not seroconvert. Participants who seroconvert will discontinue PrEP and will have a post-drug discontinuation visit 4 weeks after discontinuing PrEP. At most visits, participants will undergo blood, urine, and hair sample collection; give a medical history; undergo a physical exam; receive risk-reduction counseling and condoms; undergo testing for HIV and other STDs; receive study drugs; and undergo a pill count and adherence assessment (follow-up visits only). For participants who stop taking the study drug but remain in the study, urine, blood, and hair samples will not be collected at 12-week follow-up visits if all stop procedures have been completed and if there are no lab abnormalities that require additional follow-up. Participants will also answer questionnaires at screening, 12-week visits, and at study exit.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
557 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Emtricitabine (FTC)/tenofovir disoproxil fumarate (TDF)
Arm Type
Experimental
Arm Description
All study participants will be assigned to this arm and will receive one FTC/TDF tablet orally once a day.
Intervention Type
Drug
Intervention Name(s)
FTC 200 mg/TDF 300 mg fixed-dose combination tablet
Other Intervention Name(s)
Truvada
Intervention Description
Each participant will be directed to take one FTC/TDF tablet orally once a day, with or without food.
Primary Outcome Measure Information:
Title
Measurement of Acceptance Rate of PrEP
Time Frame
Measured through enrollment (Week 0)
Title
Measurement of Refusal Rate of PrEP
Time Frame
Measured through enrollment (Week 0)
Title
Duration of PrEP Use
Description
Number of study drug interruptions
Time Frame
Participants were followed for 48 weeks, or up to the point of early termination
Title
Duration of PrEP Use
Description
Mean duration of interruptions
Time Frame
Participants were followed for 48 weeks, or up to the point of early termination
Title
Measurement of Side Effects/Toxicities
Time Frame
Participants were followed for 48 weeks, or up to the point of early termination
Title
Measurement of PrEP Adherence by TFV-DP Levels in DBS
Time Frame
Participants were followed for 48 weeks, or up to the point of early termination
Title
Number of Male Sexual Partners
Time Frame
Participants were followed for 48 weeks, or up to the point of early termination
Title
Measurement of PrEP Adherence by Medication Possession Ratio
Description
Medication possession ratio is defined as the number of dispensed pills divided by the number of days between visits
Time Frame
Participants were followed for 48 weeks, or up to the point of early termination
Secondary Outcome Measure Information:
Title
Number of Participants Who Seroconvert
Time Frame
Participants were followed for 48 weeks, or up to the point of early termination
Title
Measurement of HIV Drug Resistance Patterns Among Participants Who Become Infected
Time Frame
Participants were followed for 48 weeks, or up to the point of early termination

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Must be either a man who has sex with men or a transgender female Male sex (at birth) Willing and able to provide written informed consent HIV-1 uninfected, defined as having a negative rapid HIV antibody test at both screening visit and enrollment and a negative 4th generation antibody/antigen test at screening No laboratory evidence of a detectable HIV viral load (San Francisco site only) Evidence of risk of acquiring HIV-1 infection including any one of the following: (1) Condomless anal sex with two or more male or transgender female sex partners during the last 12 months; or (2) two or more episodes of anal sex with at least one HIV-positive partner during the last 12 months; or (3) sex with a male or transgender female partner and any of the following STDs diagnosed during the last 12 months or at screening: syphilis, rectal gonorrhea, or rectal chlamydia. Able to provide a street address of residence or phone number for themselves or two personal contacts who would know their whereabouts during the period of the demonstration project Adequate renal function: creatinine clearance of 60 ml/min or greater as estimated by the Cockcroft-Gault equation within 45 days of enrollment A urine dipstick with a negative or trace result for protein within 45 days of enrollment Fluent in English or in Spanish Exclusion Criteria: Signs or symptoms of acute HIV infection Previously diagnosed active and serious infections including active tuberculosis infection or osteomyelitis and all infections requiring parenteral antibiotic therapy (other than STDs requiring intramuscular injections of antibiotics); active clinically significant medical problems including poorly controlled cardiac disease (e.g., symptoms of ischemia or congestive heart failure) or previously diagnosed malignancy expected to require further treatment Hepatitis B surface antigen (HBsAg) positive History of pathological bone fractures not related to trauma Receiving ongoing therapy with any of the following: investigational antiretroviral agents (PEP is allowed as described in the protocol), interferon (alpha, beta, or gamma) or interleukin (e.g., IL-2) therapy, agents with significant nephrotoxic potential, other agents that may inhibit or compete for elimination via active renal tubular secretion (e.g., probenecid), and/or other investigational agents Concomitant participation in a clinical trial using investigational agents, including placebo-controlled clinical trials using such agents At enrollment, has any other condition that, based on the opinion of the investigator or designee, would preclude provision of informed consent; make participation in the project unsafe; complicate interpretation of outcome data; or otherwise interfere with achieving the project objectives
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Albert Liu, MD, MPH
Organizational Affiliation
San Francisco Department of Public Health
Official's Role
Study Chair
Facility Information:
Facility Name
SF City Clinic Non-Network CRS
City
San Francisco
State/Province
California
ZIP/Postal Code
94103
Country
United States
Facility Name
Whitman Walker Non-network CRS
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20009
Country
United States
Facility Name
Miami PrEP Non-Network CRS
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
21091279
Citation
Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, Goicochea P, Casapia M, Guanira-Carranza JV, Ramirez-Cardich ME, Montoya-Herrera O, Fernandez T, Veloso VG, Buchbinder SP, Chariyalertsak S, Schechter M, Bekker LG, Mayer KH, Kallas EG, Amico KR, Mulligan K, Bushman LR, Hance RJ, Ganoza C, Defechereux P, Postle B, Wang F, McConnell JJ, Zheng JH, Lee J, Rooney JF, Jaffe HS, Martinez AI, Burns DN, Glidden DV; iPrEx Study Team. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010 Dec 30;363(27):2587-99. doi: 10.1056/NEJMoa1011205. Epub 2010 Nov 23.
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Assessment of Pre-Exposure Prophylaxis (PrEP) Administered at Sexually Transmitted Disease (STD) Clinics

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