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Pepped on Pre-exposure Prophylaxis (PrEP): A Counseling and Problem-Solving PrEP Adherence Intervention for Stimulant Using Men Who Have Sex With Men (MSM).

Not Applicable
Completed
Conditions
Stimulant Abuse
PrEP Uptake
Adherence, Medication
Interventions
Behavioral: Pepped on PrEP Package
Registration Number
NCT03137342
Lead Sponsor
Brown University
Brief Summary

Pepped on PrEP is an innovative pilot RCT designed by an interdisciplinary team to develop a counseling and problem-solving PrEP adherence intervention with a Behavioral Activation (BA) approach that aims to re-engage participants in safe but pleasurable activities in life and addresses stimulant-abuse as well as associated factors including depression, as barriers to optimal PrEP adherence.

Detailed Description

Enrolled participants will receive a referral to the Miriam Hospital for standard of care PrEP treatment. Once prescribed PrEP through the Miriam Hospital, the study participants will be randomly assigned to one of two treatment conditions. In the intervention condition, participants will receive a two-stepped intervention which could include up to 10 free BA and risk reduction (RR) counseling sessions. Participants assigned to the comparison condition will receive the standard of care for PrEP treatment at the Miriam Hospital, which includes information about PrEP and how to obtain it, assistance from medical staff in obtaining health insurance for study participants, and information regarding local community resources.

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
15
Inclusion Criteria
  1. Age: 18 years or older
  2. Sex: assigned male sex at birth
  3. Self-reports having sex with another man in the past month while using stimulants
  4. Self-reports behavioral risk for HIV infection (consistent with the Center for Disease Control guidelines) for prescribing PrEP: condomless anal intercourse with at least one HIV-infected or unknown serostatus partner in the preceding six months)
  5. Not currently prescribed PrEP at initial visit
  6. Able to speak and understand English (for consenting and counseling)
  7. Lives in New England
Exclusion Criteria

1.) Potential participants unable to provide informed consent, including people with severe mental illness requiring immediate treatment or with mental illness limiting their ability to participate.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Pepped on PrEPPepped on PrEP PackageUsing an efficient stepped care ("adaptive") model, all participants will receive three sessions of PrEP-STEPS counseling for PrEP adherence delivered by a Masters-level or above therapist. Some individuals may require a more intensive approach. These participants will receive an additional seven counseling sessions of behavioral activation with integrated cognitive behavioral therapy (CBT) designed to reduce stimulant use and promote positive behaviors.
Primary Outcome Measures
NameTimeMethod
PrEP UptakeBaseline Stage 2

\>80% of participants who complete Stage 1 baseline and report PrEP initiation (verified by prescription) will progress to Stage 2 Baseline.

Improve rate of PrEP adherenceBaseline Stage 2 and four month assessment

Self report adherence to assess for change in adherence.

Secondary Outcome Measures
NameTimeMethod
Reduce Unsafe SexBaseline Stage 1,Baseline Stage 2 and four month assessment

Self report sexual history to assess for change in sexual risk.

Reduce Stimulant UseBaseline Stage 1,Baseline Stage 2 and four month assessment

Self report stimulant use to assess for change in drug use.

Trial Locations

Locations (1)

Brown University School of Public Health

🇺🇸

Providence, Rhode Island, United States

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