MedPath

PrEP Affect Regulation Treatment Innovation

Not Applicable
Active, not recruiting
Conditions
HIV Prevention
Stimulant Use
Medication Adherence
Interventions
Behavioral: PARTI
Behavioral: Attention-Control
Behavioral: Contingency Management for PrEP Adherence
Registration Number
NCT04899024
Lead Sponsor
Florida International University
Brief Summary

This multi-site randomized controlled trial enrolling sexual minority men who use stimulants and are currently taking pre-exposure prophylaxis (PrEP). This randomized controlled trial will test the efficacy of a PrEP Affect Regulation Treatment Innovation (PARTI) condition comprised of a 5-session positive affect intervention delivered during smartphone-based Contingency Management (CM) for directly observed PrEP doses (PARTI+CM) compared to an attention-control condition delivered during CM. The primary outcome is HIV acquisition risk measured using a combination of tenofovir-diphosphate levels in dried blood spots that are indicative of sub-optimal adherence to PrEP and recent condomless anal sex.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
Male
Target Recruitment
239
Inclusion Criteria
  • Assigned male at birth
  • Identifies as male
  • Age 18 or older
  • Reads and speaks English
  • Reports condomless anal sex (CAS) with men in the past 6 months
  • self-reported HIV negative
  • Active prescription for daily oral PrEP for at least 2 months and reports any non-adherence in the past month OR initiated daily oral PrEP in the past 2 months, regardless of self-reported adherence
  • Has an iPhone or Android smartphone
  • Screens positive for a moderate or severe stimulant use disorder with an abbreviated version of the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST; total score of 4 or more) OR reports using stimulants at least weekly in the past 3 months.
  • Lives in California or Florida with no plans to move out of state in the next 6 months
Exclusion Criteria
  • Unable or unwilling to provide informed consent
  • Unwilling to upload upload 3 video recordings of directly observed PrEP doses using a smartphone application
  • Identifies as transfeminine (e.g., transgender woman)
  • Unable or Unwilling to provide dried blood spot (DBS) specimen at baseline
  • Switched from daily oral PrEP with disoproxil fumarate (TDF) to daily oral PrEP with tenofovir alafenamide (TAF) in the past 5 months

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PARTI and CM (Contingency Management)PARTIThe PARTI intervention will be delivered in five individual sessions during a 12-week contingency management protocol for PrEP adherence
PARTI and CM (Contingency Management)Contingency Management for PrEP AdherenceThe PARTI intervention will be delivered in five individual sessions during a 12-week contingency management protocol for PrEP adherence
Attention-Control and CM (Contingency Management)Attention-ControlThe attention-control condition will consist of five individual sessions where participants complete self-report measures and neutral writing exercises during a 12-week contingency management protocol for PrEP adherence
Attention-Control and CM (Contingency Management)Contingency Management for PrEP AdherenceThe attention-control condition will consist of five individual sessions where participants complete self-report measures and neutral writing exercises during a 12-week contingency management protocol for PrEP adherence
Primary Outcome Measures
NameTimeMethod
Percentage of Participants Engaging HIV Acquisition RiskUp to 12 months

Percentage of participants engaging in HIV acquisition risk (i.e., defined as tenofovir - diphosphate levels \< 700 fmol per punch from dried blood spots and any self-reported recent condomless anal sex)

Secondary Outcome Measures
NameTimeMethod
PrEP PersistenceUp to 12 months

Percentage of participants who continue taking PrEP medication

Self-Reported Stimulant Use SeverityUp to 12 months

The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) provides validated composite scores indexing the severity of cocaine and amphetamine use (Mild = 0-3; Moderate = 4-26; Severe = 27 or greater).

Positive AffectUp to 12 months

Mean positive affect score as measured by the modified Differential Emotions Scale (Range 0-104) with higher scores being indicative of higher positive affect.

Retention in PrEP CareUp to 12 months

Percentage of participants who report attending a medical visit with the PrEP provider in the past three months

Trial Locations

Locations (2)

University of California, San Francisco

🇺🇸

San Francisco, California, United States

University of Miami Miller School of Medicine

🇺🇸

Miami, Florida, United States

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