Oral Islatravir (MK-8591) Once-Monthly as Preexposure Prophylaxis (PrEP) in Men and Transgender Women Who Are at High Risk for HIV-1 Infection (MK-8591-024) (Impower-024)
HIV Preexposure Prophylaxis

About this trial
This is an interventional prevention trial for HIV Preexposure Prophylaxis focused on measuring Preexposure prophylaxis (PrEP), Prevention
Eligibility Criteria
Inclusion Criteria:
- Has confirmed Human Immunodeficiency Virus (HIV) uninfected based on negative HIV-1/HIV-2 test result before randomization
- Is sexually active with male or transgender women (TGW) partners defined as having anal sexual intercourse with a man or TGW at least once in the past month
- Is at high risk for sexually acquiring HIV-1 infection based on self-report of at least 1 of the following: a) Condomless receptive anal intercourse in the 6 months prior to screening occurring outside a mutually monogamous HIV seronegative concordant relationship b) More than 5 partners (anal intercourse) in the 6 months prior to screening c) Any unprescribed stimulant drug use in the 6 months prior to screening d) Rectal or urethral gonorrhea or chlamydia or incident syphilis in the 6 months prior to screening
- Participants 16 or 17 years of age must weigh ≥35 kg. Enrollment for 16- to 17-year-old participants will begin only after completion of the Sentinel Cohort IA and review of IA results by the external data monitoring committee (eDMC)
- Has no plans to relocate or travel away from the site for ≥4 consecutive weeks during study participation
Exclusion Criteria:
- Has hypersensitivity or other contraindication to any component of the study interventions as determined by the investigator
- Has chronic HBV infection or past HBV infection which could indicate risk for Hepatitis B reactivation
- Has known current or chronic history of liver disease or known hepatic or biliary abnormalities, unless the participant has stable liver function tests and no evidence of hepatic synthetic dysfunction
- Has a history of malignancy within 5 years of screening except for adequately treated basal cell or squamous cell skin cancer or in situ anal cancers
- Has a history or current evidence of any condition, therapy, laboratory abnormality or other circumstance that might, in the opinion of the investigator, confound the results of the study or interfere with the participant's participation for the full duration of the study, such that it is not in the best interest of the participant to enroll
- Has taken cabotegravir, lenacapavir, or any other long-acting HIV prevention product at any time
- Is currently receiving or is anticipated to require any prohibited therapies outlined in the study from 30 days prior to Day 1 through the duration of the study
- Is currently participating in or has participated in an interventional or prevention clinical study with an investigational compound or device, within 30 days prior to Day 1 through the duration of the study
- Has exclusionary laboratory values within 45 days prior to Day 1
Sites / Locations
- University of Alabama at Birmingham-UAB 1917 Research Clinic ( Site 0007)
- UCLA Center for Clinical AIDS Research and Education ( Site 0011)
- Global Research Institute ( Site 0031)
- Bridge HIV - San Francisco Department of Public Health ( Site 0003)
- The GW Medical Faculty Associates-Medicine ( Site 0033)
- Midway Immunology and Research Center ( Site 0014)
- University of Miami Miller School of Medicine-Infectious Disease ( Site 0029)
- Orlando Immunology Center ( Site 0010)
- Ponce De Leon Center Grady Health ( Site 0032)
- Howard Brown Health Center ( Site 0004)
- The University of Mississippi Medical Center ( Site 0012)
- Rutgers New Jersey Medical School-Clinical Research Center ( Site 0017)
- The University of North Carolina at Chapel Hill ( Site 0019)
- Central Texas Clinical Research ( Site 0002)
- The Crofoot Research Center ( Site 0025)
- Centro de Referência e Treinamento DST/AIDS ( Site 0351)
- Hôpital Saint-Louis-Infectious Diseases and tropical diseases ( Site 0151)
- Center Hospital of the National Center for Global Health and Medicine ( Site 0101)
- Via Libre ( Site 0404)
- Perinatal HIV Research Unit (PHRU)-HIV Prevention CRS ( Site 0203)
- Wits Reproductive Health and HIV Institute (WRHI)-Research Center ( Site 0201)
- Desmond Tutu HIV Foundation ( Site 0202)
- Chulalongkorn University-Pediatrics ( Site 0051)
- HIV Netherlands Australia Thailand Research Collaboration ( Site 0056)
- Research Institute for Health Sciences-Research Institute for Health Sciences Building 1 ( Site 0052
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Islatravir (ISL) Once Monthly (QM) Group
FTC/TDF or FTC/TAF QD Group
Participants receive 60 mg tablet of ISL QM, orally plus Placebo to Emtricitabine/Tenofovir Disoproxil Fumarate (FTC/TDF) tablet once daily (QD) or Placebo to Emtricitabine/Tenofovir Alafenamide (FTC/TAF) tablet QD, orally for up to 24 months of treatment duration.
Participants receive 200/245 mg or 200/300 mg of FTC/TDF combination tablet, QD, orally or 200/25 mg of FTC/TAF combination tablet, QD, orally at investigator's discretion plus Placebo to ISL tablet QM, orally for up to 24 months of treatment duration.