Clinical Trials

MainTitle

Decision Support Intervention Adapted for HIV Pre-Exposure Prophylaxis for Adoption and Adherence for Black Canadians (PrEPDSA)

This study is currently recruiting participants. (see Contacts and Locations)

Verified April 2019 by St. Michael's Hospital, Toronto

Sponsor
St. Michael's Hospital, Toronto


Information provided by (Responsible Party)
St. Michael's Hospital, Toronto
ClinicalTrials.gov Identifier
NCT03637244

First received: January 22, 2018
Last updated: April 10, 2019
Last Verified: April 2019
History of Changes
Purpose

Purpose

Aim 1: Adapt Ottawa Decision Support Framework for the HIV PrEP decisional needs of African, Caribbean and Black (ACB) Canadian patients Aim 2. Pilot Test The Adapted Decision-Support Intervention Using a Two-Arm Randomized Controlled Design

Condition Intervention
HIV/AIDS

Behavioral : Decision Support Aid and PrEP for Black Canadians

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Intervention Model Description: H1: PrEP decision support increases decision quality in both LDQ and HDQ groups, H2: HDQ + decision-support group more likely to initiate PrEP than HDQ control, H3: HDQ PrEP initiators are more likely than LDQ initiators to have serum levels consistent with adherence at 60-days. Investigators supply one smartphone/ participant,each registered to St. Mike's Hospital to protect participant privacy. The decision support aid will be a pre-programmed bookmark, an RA will give participants a brief tutorial on its use. Patients assigned to the experimental condition (LDQ + DS and HDQ + DS) will use the bookmarked link to the decision-aid within the first 7-14 days (and thereafter as needed) during the study period. The routine care group will be asked to use a bookmarked link to frequently asked questions on tenofovir + emtricitabine for PrEP. All groups will be compared on decision-quality at 14-days, self-reported PrEP initiation at 30-days, and PrEP adherence at 60-days post enrollment.
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: Pilot Randomized Controlled Trial of a Decision Support Intervention Adapted for HIV Pre-Exposure Prophylaxis Adoption and Adherence Among African, Caribbean and Black Canadian Patients

Further study details as provided by St. Michael's Hospital, Toronto:

Primary Outcome Measures

  • Change in baseline (initiation of PrEP) to adherence of PrEP for ACB Canadians [ Time Frame: Self-reported PrEP initiation at 30-days and PrEP adherence at 60-days post enrollment. ]
    PrEP Initiation (does the person fill a prescription for PrEP) PrEP Adherence (analysis of intracellular tenofovir+emtricitabine concentration in dried blood spot)

Estimated Enrollment: 90
Study Start Date: April 9, 2019
Estimated Study Completion Date: January 15, 2020
Estimated Primary Completion Date: October 15, 2019 (Final data collection date for primary outcome measure)

Arms Assigned Interventions
Experimental: Experimental Condition
Patients assigned to the experimental condition (LDQ + DS and HDQ + DS) will be asked to use the bookmarked link to the decision-aid within the first 7-14 days (and thereafter as needed) during the study period. The routine care group will be asked to use a bookmarked link to frequently asked questions on tenofovir + emtricitabine for PrEP. All groups will be compared on decision-quality at 14-days, self-reported PrEP initiation at 30-days, and PrEP adherence at 60-days post enrollment.
Behavioral: Decision Support Aid and PrEP for Black Canadians

Ottawa Decision Support Framework Adaptation.Investigators will use the inputs from the qualitative findings, CDC public health guidance and the tenofovir + emtricitabine product monograph to tailor the ODSF for use in the C5TM PrEP decision support web-app.

Detailed Description:

Aim 1: Adapt Ottawa Decision Support Framework for the HIV PrEP decisional needs of ACB Canadian patients. Investigators propose a cross-sectional qualitative descriptive study using data collected from key informant interviews with PrEP eligible patients and surveys with health professionals involved in HIV PrEP management. Under this aim two research questions will be investigated.
Q1) What factors do ACB Canadian patients consider when deciding whether to adopt HIV PrEP? Q2. How do SDT constructs of autonomy, competence and relatedness influence ACB Canadian's decision-making experiences regarding PrEP adoption?
AIM 2. Pilot Test The Adapted Decision-Support Intervention Using a Two-Arm Randomized Controlled Design.Hypothesis testing will be de-emphasized in favor of generating effect size estimates. Under this aim three research questions will be investigated. Preliminary hypotheses include:
H1: PrEP decision support increases decision quality in both LDQ and HDQ groups, H2: HDQ + decision-support group more likely to initiate PrEP than HDQ control, H3: HDQ PrEP initiators are more likely than LDQ initiators to have serum levels consistent with adherence at 60-days.
Data on decision quality survey and PrEP initiation data will generated by the subject from self-administered assessments via the decision-support app on the study-issued smartphone. Investigators will also collect biological specimens to measure adherence to HIV PrEP at 60-days post enrollment.
The study will take place in the Toronto metropolitan area (pop. 2.5 million). Over half (59%) of Canada's ACB population is settled in the province of Ontario. Moreover, the majority (70%) of ACB people in Ontario live in metro Toronto, making it the ideal location for this study. The trial procedures will be conducted at sites within the St. Michael's Hospital (SMH) system, including the SMH Li Ka Shing Knowledge Institute.

Eligibility

Eligibility

Ages Eligible for Study: 18 Years and older  
Sexes Eligible for Study: All  
Accepts Healthy Volunteers: Yes  

Criteria

Inclusion Criteria

  • Self identify as Black African, Caribbean and or Canadian
  • HIV sero-negative
  • Not in a monogamous sexual partnership with a recently tested HIV negative man
  • Self report unprotected anal sex with a man in the past six months
  • Diagnosed with gonorrhea, chlamydia or syphilis in the past six months
  • Are in an ongoing sexual relationship with an HIV positive partner
  • Currently live in the Greater Toronto metropolitan area
  • Can speak and understand either English or French

  • Exclusion Criteria
  • Non Black African Caribbean and or Canadian person
  • Diagnosed with HIV and or AIDS
  • Unable to consent to provide documentation of negative HIV status

contacts and locations

Contacts and Locations

Choosing to participate in a study is an important personal decision.Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below.For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT03637244

Contacts

Contact:   LaRon E Nelson, PhD 416-864-6060 ext 77340 nelsonla@smh.ca
Contact:   Pascal Djiadeu, PhD 416-360-4000 ext 77370 djiadeup@smh.ca

Locations

Canada
St. Michael's Hospital Academic Family Health Team Recruiting
Toronto, Ontario, Canada, M5B 1T8
Contact: Rebecca Brown    416-864-6060 ext 77492    BrownRe@smh.ca
Contact: Cheryl Pedersen    416-864-6060 ext 77374    PedersenC@smh.ca
Principal Investigator: Aisha Lofters, MD

Sponsors and Collaborators

St. Michael's Hospital, Toronto

Investigators

Principal Investigator: LaRon E Nelson, PhD St. Michael's Hospital, Toronto
More Information

More Information


Responsible Party: St. Michael's Hospital, Toronto  
ClinicalTrials.gov Identifier: NCT03637244   History of Changes  
Other Study ID Numbers: StMichaelnelsonla  
Study First Received: January 22, 2018  
Last Updated: April 10, 2019  
Individual Participant Data    
Plan to Share IPD: No  

Studies a U.S. FDA-regulated Drug Product: No  
Studies a U.S. FDA-regulated Device Product: No  

Keywords provided by St. Michael's Hospital, Toronto:

HIV PrEP Decision support African Caribbean Black Canadians

Additional relevant MeSH terms:
Emtricitabine

ClinicalTrials.gov processed this data on December 13, 2019
This information is provided by ClinicalTrials.gov.