Biobehavioral Interventions for HIV-negative, Stimulant Using Men Who Have Sex With Men
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Purpose
This study seeks to evaluate the efficacy of a contingency management (CM) intervention compared to a yoked control condition for eliminating illicit stimulant use and for decreasing time to initiating post exposure prophylaxis (PEP), for improving adherence to PEP, and for completing PEP following a potential HIV-exposure event. Men who have sex with men who use cocaine amphetamine or methamphetamine frequently also have high risk sexual behaviors during or after their drug use. The objective of this study evaluates whether the use of CM that targets stimulant use significantly aids men who have sex with men who use stimulants and also engage in high-risk sexual transmission behaviors to be able to initiate, adhere to and complete PEP, thereby optimizing the utility of a biomedical HIV prevention intervention for reducing HIV incidence in this very high-risk group of MSM.
| Condition | Intervention | Phase |
|---|---|---|
|
Stimulant-Related Disorders HIV HIV Infections |
Drug: Truvada |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | Optimizing Access to Non-occupational Post Exposure Prophylaxis for HIV Using Contingency Management in Stimulant-Using Men Who Have Sex With Men |
- Initiation, adherence and completion of Post-exposure Prophylaxis. [ Time Frame: 6-month follow-up ] [ Designated as safety issue: Yes ]Initiation is defined as starting Post-exposure Prophylaxis at any point after randomization to Contingency Management Condition (active, yoked control); Adherence is self-report and pill count of PEP medications; Completion is completion of the 28 day medication regimen, if started.
- Abstinence from stimulant drug use (cocaine, amphetamine, methamphetamine) [ Time Frame: 6-month follow-up ] [ Designated as safety issue: Yes ]Abstinence will be measured using thrice weekly urine drug screens and self-report
| Estimated Enrollment: | 165 |
| Study Start Date: | May 2010 |
| Estimated Study Completion Date: | March 2013 |
| Estimated Primary Completion Date: | March 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Contingency Management
Participants will submit a urine sample every Monday, Wednesday, and Friday for 8 weeks (a total of 24 urine samples). Samples will be tested for stimulant metabolites. Increasingly valuable incentives will be provided for urine samples that lack metabolites of stimulant drugs.
|
Drug: Truvada
Truvada At qualifying exposure, participants will take 28 days' worth (at one pill per day) of 200 mg emtricitabine and 300 mg tenofovir DF (Truvada).
|
|
Sham Comparator: Yoked Contingency Management
Participants will submit a urine sample every Monday, Wednesday, and Friday for 8 weeks (a total of 24 urine samples). Samples will be tested for stimulant metabolites. Incentives will be provided to participants independent of stimulant drug use and determined in the same rate and timing as a randomly selected participant in the active CM condition.
|
Drug: Truvada
Truvada At qualifying exposure, participants will take 28 days' worth (at one pill per day) of 200 mg emtricitabine and 300 mg tenofovir DF (Truvada).
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Male |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Male who has sex with other men (MSM) by self-report
- At least 18 years of age
- HIV-negative serostatus on baseline rapid oral HIV antibody test, and no signs or symptoms consistent with primary HIV infection (PHI)
- Self-reported stimulant use within the previous 30 days
- Self-report of unprotected anal intercourse (either receptive or insertive) with an HIV-positive or status unknown partner within the previous 3 months
- Self-report of no previous hypersensitivity to any of the components of Truvada (tenofovir disoproxil fumarate or emtricitabine)
- In the opinion of the study medical provider, no contraindication to PEP medication treatment (laboratory testing, medical/drug interaction, or other)
- Has not used PEP in the previous 6 months
- A current resident of Los Angeles County
- Does not have a plan to move away from Los Angeles County in the next 6 months
- Willing and able to provide informed consent
- Willing and able to comply with study requirements
Exclusion Criteria:
- Does not identify as a male who has sex with other men
- Under 18 years of age
- HIV positive by self-report or as indicated by the results on baseline rapid oral HIV antibody testing
- Has not used a stimulant in the previous 30 days by self-report
- Has not had unprotected anal intercourse (either receptive or insertive) with an HIV-positive or status unknown partner within the previous 3 months
- Creatinine clearance <30 ml/min and not on dialysis
- Self-reports any previous hypersensitivity to any of the components of Truvada (tenofovir disoproxil fumarate or emtricitabine);
- In the opinion of the study medical provider, there exists a contraindication to administering Truvada-based post-exposure prophylaxis (laboratory testing, medical/drug interaction, or other)
- Has used PEP in the previous six months
- Not a current resident of Los Angeles County
- Unwilling or unable to provide informed consent
- Unwilling or unable to comply with study requirements
Contacts and Locations| United States, California | |
| Friends Community Center, A Division of Friends Research Institute, Inc. | |
| Los Angeles, California, United States, 90028 | |
| Principal Investigator: | Cathy J. Reback, Ph.D. | Friends Research Institute, Inc. |
| Principal Investigator: | Raphael J. Landovitz, M.D., M.Sc. | UCLA Center for Clinical AIDS Research and Education |
| Principal Investigator: | Steven Shoptaw, Ph.D. | UCLA Department of Family Medicine |
More Information
Additional Information:
No publications provided
| Responsible Party: | Cathy Reback, Principal Investigator, Friends Research Institute, Inc. |
| ClinicalTrials.gov Identifier: | NCT01140880 History of Changes |
| Other Study ID Numbers: | MC08-LA-710-FRI |
| Study First Received: | June 8, 2010 |
| Last Updated: | August 23, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Friends Research Institute, Inc.:
|
Methamphetamine Amphetamine Cocaine |
HIV Post-exposure prophylaxis HIV seronegativity |
Additional relevant MeSH terms:
|
HIV Infections Acquired Immunodeficiency Syndrome Lentivirus Infections Retroviridae Infections RNA Virus Infections Virus Diseases Sexually Transmitted Diseases, Viral Sexually Transmitted Diseases |
Immunologic Deficiency Syndromes Immune System Diseases Slow Virus Diseases Central Nervous System Stimulants Physiological Effects of Drugs Pharmacologic Actions Central Nervous System Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on June 17, 2013