Hepatitis B Virus (HBV) Prevention for Homeless at Risk for HBV/Hepatitis C Virus (HCV)/HIV (HBV)
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ClinicalTrials.gov Identifier: NCT00926146 |
Recruitment Status
:
Completed
First Posted
: June 23, 2009
Last Update Posted
: January 30, 2017
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Condition or disease | Intervention/treatment | Phase |
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Hepatitis B Hepatitis C HIV HIV Infections | Behavioral: NCMIT Behavioral: SCMIT | Not Applicable |
Homeless adults are at high risk for Hepatitis B virus (HBV), Hepatitis C virus (HCV) and HIV infection due to high rates of injection drug use and unprotected sexual activity. Our NIDA-funded RO1 award has enabled us to implement a successful intervention designed to evaluate the effectiveness of a HBV vaccination intervention with homeless adults. Our findings revealed that a greater percent of homeless adults randomized to the Nurse Case Managed Plus Incentive and Tracking group completed the HAV/HBV vaccine series compared to a Standard program without tracking. Homeless persons least likely to complete the vaccine series were young (< 40), and were men having sex with men (MSM); a significant number of these young adults also reported methamphetamine (MA) and cocaine/crack use. Stimulants (SAs), including MA and cocaine/crack are commonly used by homeless MSM, who contend with disorganized lives, unemployment, and little access to health and social services; thus, HBV vaccination is particularly challenging in this population. HAV/HBV vaccination and effective behavioral treatment are two of the most important strategies for reducing HBV infection among this at-risk group of SA users.
Based upon advice from our community partners who have successfully treated SA-using gay and bisexual men (GBM), we will incorporate contingency management into our vaccination completion program, which had lower completion rates among young adults and MSMs. Thus, in this competitive renewal, we propose a randomized, experimental, two-group design to evaluate the effectiveness of a Nurse Case Managed Program, which includes specialized education and Contingency Management and Tracking (NCCMT), with a Standard Program, including brief education, Contingency Management and Tracking (SCMT) with 500 homeless, young (18-39), SA-using GBM, on completion of the Twinrix HAV/HBV vaccine and, secondarily, on reduction of risk for hepatitis and HIV. This study is innovative in that it will allow us to look at the effect of an enhanced case management and contingency management program versus a standard contingency management program. The proposed study combines optimal strategies to approach, engage and intervene with a hidden and high-risk population to assess the feasibility and efficacy of interventions that may prove beneficial in preventing HBV and HAV infections. We will also assess the relative cost of these programs in terms of completion of the HAV/HBV vaccination series. As use of SAs threatens to intensify homeless persons' risk of exposure to HAV and HBV, particularly among young users who may not yet be HBV-infected, research targeted to engage this group in treatment, until they are suitably protected from HBV, is critical.
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 451 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Prevention |
Official Title: | HBV Prevention for Homeless at Risk for HBV/HCV/HIV |
Study Start Date : | July 2009 |
Actual Primary Completion Date : | January 2014 |
Actual Study Completion Date : | February 2015 |

Arm | Intervention/treatment |
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Experimental: NCMIT
Nurse Case Management Plus Contingency Management and Tracking and the HBV vaccine
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Behavioral: NCMIT
Nurse Case Management Plus Contingency Management and Tracking (NCCMT) Program includes 20 minute case management, delivered by the NCCMT nurse and a separate 45 minute culturally competent specialized education, delivered by the two assigned nurses and research assistants weekly over 8 weeks. Participants of this group will also receive the HBV vaccine subsequently at one month and four months after baseline and incentives for three-weekly urine samples.
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Active Comparator: SCMIT
Standard with Contingency Management and Tracking (SCMT) and HBV vaccine
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Behavioral: SCMIT
Standard with Contingency Management and Tracking (SCMT) Program. Participants in the SCMT group will interact three times a week over the four-month intervention period with the research nurse and research assistant and will be offered: 1) a brief HBV/HCV education program; 2) receipt of the vaccine subsequently at one month and four months after baseline; and 3) voucher incentives for three-weekly urine samples. The SCMT participants will not receive the specialized education sessions nor the case management delivered weekly over the first 8 weeks sessions.
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- Compare the NCMIT and SCMT programs among homeless young gay and bisexual stimulant using men with respect to completion of a HBV vaccination series administered in three doses over a four-month period. [ Time Frame: 5 years ]
- Document the occurrences of HCV and HIV infections as baseline among these homeless HBV antibody negative stimulant users, and the factors associated with these infections at baseline. [ Time Frame: 5 years ]

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Ages Eligible for Study: | 18 Years to 39 Years (Adult) |
Sexes Eligible for Study: | Male |
Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- homeless males self-reporting gay or bisexual behaviors in the last 12 months
- age 18-39
- methamphetamine and/or cocaine/crack use currently or in the last three months
- no self-reported participation in drug treatment in the last 30 days
- willing to provide informed consent
- willing to undergo hepatitis B and C and HIV antibody testing at baseline
- found to be HBV antibody negative
Exclusion Criteria:
- persons with Guillian Barre, or allergy to yeast or neomycin
- monolingual speakers of languages other than English or Spanish
- persons judged to be cognitively impaired by the nurse

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00926146
United States, California | |
Friends Community Center | |
Los Angeles, California, United States, 90028 |
Principal Investigator: | Adeline Nyamathi, PhD | University of California, Los Angeles |
Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | Adeline Nyamathi, PhD, Distinguished Professor, University of California, Los Angeles |
ClinicalTrials.gov Identifier: | NCT00926146 History of Changes |
Other Study ID Numbers: |
090602901 DA016147 ( Other Grant/Funding Number: NIDA ) |
First Posted: | June 23, 2009 Key Record Dates |
Last Update Posted: | January 30, 2017 |
Last Verified: | January 2017 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Keywords provided by Adeline Nyamathi, PhD, University of California, Los Angeles:
Hepatitis B and C HIV nurse case management HIV seronegativity |
Additional relevant MeSH terms:
Hepatitis Hepatitis A Hepatitis C HIV Infections Hepatitis B Liver Diseases Digestive System Diseases Hepatitis, Viral, Human Virus Diseases Enterovirus Infections Picornaviridae Infections RNA Virus Infections |
Flaviviridae Infections Lentivirus Infections Retroviridae Infections Sexually Transmitted Diseases, Viral Sexually Transmitted Diseases Immunologic Deficiency Syndromes Immune System Diseases Hepadnaviridae Infections DNA Virus Infections Vaccines Immunologic Factors Physiological Effects of Drugs |