PrEP Point-of-Care Brief-Intervention for Adherence Among Young Men Who Have Sex With Men
概览
- 阶段
- 不适用
- 干预措施
- Motivational Interviewing Counselling
- 疾病 / 适应症
- Risk Reduction
- 发起方
- University of California, San Francisco
- 入组人数
- 63
- 试验地点
- 1
- 主要终点
- Number of Participants Indicating the Intervention Was Acceptable
- 状态
- 已完成
- 最后更新
- 2个月前
概览
简要总结
Despite advances in HIV prevention, the HIV incidence among young men who have sex with men (YMSM) is increasing, threatening to derail achievement of the United States End the HIV Epidemic goals. Although, pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention method, adherence was sufficiently low to comprise efficacy among a high proportion of YMSM in multiple clinical trials and demonstration projects. In this study, the investigators will leverage a novel urine point-of-care drug-level test for PrEP adherence, to both enhance and target motivational-interviewing-based adherence counseling among YMSM, with the goal of preventing HIV infections among this critically at-risk group.
详细描述
Young men who have sex with men (YMSM; ages 15-29 years) have rising HIV incidence in the United States. Pre-exposure prophylaxis (PrEP) is a highly effective medication prevent HIV infection, both at the individual and population level. However, in several clinical trials and demonstration projects among YMSM, a majority of participants had adherence to PrEP sufficiently low to compromise efficacy throughout the study. Unfortunately, pill-counts and self-reported adherence have limitations in this population, and therapeutic drug monitoring using previously available methods requires expensive equipment and specialized staff, meaning it cannot be implemented at the point-of-care (POC). The investigators have developed a novel POC test to measure urine drug-levels to PrEP for the first time, providing the opportunity to target and enhance adherence counseling during a routine clinical visit. Substantial knowledge gaps on the correct counseling approach and framing of the drug-level feedback message must be addressed to use this strategy to improve adherence among YMSM. This study will use a mixed methods approach to test the central hypothesis that an intervention leveraging a POC urine bioassay to detect PrEP adherence can both target and enhance adherence counseling. Brief interventions are a motivational interviewing (MI) counseling approach with wide uptake by primary care providers for substance use prevention and medical therapy adherence. PrEP2-BAY proposes a brief intervention be used as the framework for POC drug-level feedback among YMSM using PrEP. This study will test the acceptability, feasibility, and preliminary impact on long-term adherence, measured through hair tenofovir levels, of the brief intervention in a pilot randomized controlled trial among YMSM. This proposed research plan has the goal of optimizing PrEP's impact through a novel adherence support intervention. The findings of this proposal will lead to a R01 application to test a POC bioassay-enhanced adherence brief intervention among YMSM in a multi-city trial, with the goal of reducing the burden of HIV among MSM.
研究者
入排标准
入选标准
- •Male sex at birth who has sex with men
- •Age 18-30 years-old
- •Currently receiving tenofovir-based oral PrEP
- •Plans to continue taking daily PrEP over the upcoming 3 months
排除标准
- •Participant living with HIV
- •Age \> 30 years
研究组 & 干预措施
Intervention Arm
POC adherence testing by a urine tenofovir assay with motivational interviewing counselling
干预措施: Motivational Interviewing Counselling
Intervention Arm
POC adherence testing by a urine tenofovir assay with motivational interviewing counselling
干预措施: Point-of-care Urine Tenofovir Measurement
Standard of Care
Adherence counselling provided by the participant's PrEP care provider
结局指标
主要结局
Number of Participants Indicating the Intervention Was Acceptable
时间窗: 3 months
Number of participants reporting the intervention to be "somewhat" or "very" acceptable on a five-point Likert scale
次要结局
- Long-term Adherence Outcomes(3 months)