AzTrials
AzTrials

HIVNCT02043015

Comprehensive HIV Prevention Package for MSM in Southern Africa: Pilot Study (Sibanye Health Project)

A study testing Condom choices, Condom-compatible lubricant choices and Couples HIV counseling and testing (CVCT) in people with HIV, run by Emory University at 3 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of this study is to evaluate the acceptability and uptake of a combination package of biomedical, behavioral and community-level HIV prevention interventions and services for men who have sex with men (MSM) in South Africa. Read more about this study

Who is it for?
Ages 18 years and older, men onlyHealthy volunteers can take part
Conditions the study is for
HIV
What is being tested?
Condom choices, Condom-compatible lubricant choices and Couples HIV counseling and testing (CVCT)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
100 participants
Where
3 sitesin 2 countries
Study dates
Feb 2015to Mar 2017
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Men only
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Male sex at birth
  • Anal sex with another man in the past 12 months
  • 18 years of age or older
  • Resident of the study city
  • Able to complete study instruments, with or without assistance, in English, Xhosa or Afrikaans
  • Willing to provide contact information
  • Has a phone

Who cannot join

  • Not male sex at birth
  • No self-reported anal sex with a man in the past 12 months
  • Less than 18 years of age
  • Not a resident of the study city
  • Plans to move from the study city within the year after enrollment
  • Not able to complete study instructions, with or without assistance, in English, Xhosa or Afrikaans
Show all 38Show fewer
  • Not willing to provide contact information
  • Does not have a phone
  • Additional Inclusion and Exclusion Criteria for participants on PrEP:
  • PrEP Inclusion Criteria:
  • Identified as high-risk for HIV by the provider by meeting one or more of the criteria below:
  • Have multiple partners
  • Engage in transactional sex, including sex workers
  • Use or abuse drugs
  • Drink alcohol heavily
  • Had more than 1 episode of a STI in the last year
  • Is the HIV-negative partner in a discordant relationship, especially if the HIV-positive partner is not on antiretroviral therapy (ART)
  • Is in a non-monogamous concordant relationship with a HIV-negative partner
  • Is unable or unwilling to achieve consistent use of male condoms
  • No contra-indications to Emtricitabine/Tenofovir Disoproxil Fumarate (FTC/TDF)
  • Calculated creatinine clearance of at least 60 mL/min
  • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) < 2 x upper limit of normal (ULN)
  • Hepatitis B surface antigen (HBsAg) negative
  • Motivated to follow PrEP prescribing guidelines
  • Willing to adhere to daily oral dosing
  • Willing to attend PrEP maintenance visits every 3 months
  • PrEP Exclusion Criteria:
  • HIV positive
  • Signs or symptoms suggestive of acute HIV infection
  • Have baseline creatinine clearance <60 ml/min
  • Are unwilling to follow PrEP prescribing guidelines
  • Are unwilling to attend PrEP maintenance visits every 3 months
  • Are known to have hypertensives or diabetes
  • Are hepatitis B susceptible (test HBsAg and HBsAb negative) and refuse to take a hepatitis B vaccine series
  • Any contraindication to taking FTC/TDF
  • Proteinuria 2+ or greater at screening
  • Glucosuria 2+ or greater at screening
  • Use of antiretroviral (ARV) therapy (e.g., for PEP or PrEP) in the 90 days prior to study entry

Trial locations and contacts

3 sites in 2 countries.

3 sites in 2 countries

United States2 sites
  • Rollins School of Public Health

    Atlanta, Georgia, 30322

  • Johns Hopkins School of Public Health

    Baltimore, Maryland, 21205

Other trials in United States

South Africa1 site
  • Desmond Tutu HIV Foundation

    Cape Town

Other trials in South Africa

About this study

Official title: Comprehensive HIV Prevention Package for MSM in Southern Africa: Pilot Study

The purpose of this study is to evaluate the acceptability and uptake of a combination package of biomedical, behavioral and community-level HIV prevention interventions and services for men who have sex with men (MSM) in South Africa.

Read the detailed description

Study Design:

This pilot study is a longitudinal cohort study of approximately 100 MSM, with a prospective follow-up period of 1 year for each participant. MSM will be recruited through community events, venues where MSM are known to congregate, online, and by participant referral. Following consent, a baseline visit will include a self-administered baseline survey, a clinical exam including an assessment for circumcision and STIs, and testing for HIV and other sexually transmitted infections (STIs), creatinine, AST/ALT and phosphorus levels, and drug screening.

An HIV prevention package will be offered to participants starting at baseline, which will include condom choices, condom-compatible lubricant choices, risk-reduction counseling, linkage to care, and couples voluntary counseling and testing (CVCT). HIV-negative men can be screened for eligibility for pre-exposure prophylaxis (PrEP) with Emtricitabine/Tenofovir Disoproxil Fumarate (FTC/TDF), which will be made available for eligible men beginning at the 1-month or 4-month study visit. Throughout the study, PEP for men with an exposure at high risk for HIV transmission will be made available.

Men who test positive for HIV at baseline or during the study will be referred and actively linked to appropriate care and treatment services and will continue to be a part of the study. Men who test positive for STIs at baseline or during the study will receive treatment at the study clinic. Participants will complete follow-up visits at 3, 6, and 12 months that will include self-administered behavioral surveys and HIV testing, and STI testing at 6 and 12 months.

Men who are eligible and interested in initiating PrEP can return for a PrEP initiation visit, which will include rapid HIV testing, at two time points: 1 month after enrollment and 4 months after enrollment. Men who initiate PrEP will have additional clinic visits for creatinine, AST/ALT, phosphate, protein and glucose level testing and rapid HIV testing the month following PrEP initiation (month 2 for those initiating PrEP at 1 month and month 5 for those initiating PrEP at 4 months) and every 3 months thereafter. If a participant on PrEP tests positive for HIV, they will discontinue PrEP but continue to be followed for their remaining study visits.

Men who test positive for HIV at follow-up visits will have blood drawn for initial cluster of differentiation 4 (CD4) and HIV viral load testing, and will have CD4 testing at 6 and 12 months and HIV viral load testing at 3, 6, and 12 months. Data on service utilization, condom use, lubricant use, HIV and STI testing outside the study site, and other outcomes will be collected via monthly short message service (SMS) text message surveys during the study period.

Study Population:

The study population will be men aged 18 years and older who self-report that they had anal intercourse with men in the past year, are current residents of the study city, are willing to provide contact information, and have a phone.

Study Size:

The sample will consist of approximately 100 MSM in Cape Town, South Africa. All 100 men will be followed for one year, and approximately 20% of the study population can be HIV-infected at baseline. Additional men who are HIV-positive at baseline will be enrolled in the baseline visit but not followed prospectively, and not counted as part of the 100 men in that study site.

Study Intervention:

The prevention package will be offered throughout the study and will include condom choices with an assortment of styles, sizes and features, condom-compatible lubricant choices with discreet packaging, risk reduction counseling, linkage to care, couples voluntary HIV counseling and testing (CVCT), and PrEP for eligible men beginning one month after enrollment. Condom choices, lubricant choices, and CVCT will be available to participants at drop-in visits at any time.

Throughout the study, post-exposure prophylaxis (PEP) for men with an exposure at high risk for HIV transmission will be available as standard of care.

Community-level interventions will occur through training of health care providers to deliver sexual health services to MSM and lesbian, gay, bisexual, and transgender (LGBT) sensitization, LGBT training for study staff and other staff of the clinical sites, and community mobilization efforts to improve health literacy and uptake of prevention services among MSM.

Study Duration:

Recruitment activities will be conducted for 3 months or until 100 MSM have been recruited. After enrollment, MSM will have a follow-up period of 1 year for each participant.

Primary Objectives:

This study has four primary objectives:

  1. Determine acceptability of the HIV prevention package.
  2. Determine uptake of individual elements of the HIV prevention package.
  3. Determine incidence of HIV, STIs and unprotected anal intercourse (UAI).
  4. Understand HIV risk and prevention behaviors among MSM.

Participating Sites:

  1. Emory University, Atlanta, Georgia
  2. Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  3. University of California, Los Angeles, Los Angeles, California
  4. Desmond Tutu HIV Foundation, Cape Town, South Africa (Enrollment \& Clinic site)
Conditions
HIV
Being tested
Condom choices, Condom-compatible lubricant choices, Couples HIV counseling and testing (CVCT), Pre-exposure prophylaxis with FTC/TDF, Staff and provider MSM and LGBT sensitization training
Keywords
voluntary counseling and testing (VCT), couples voluntary counseling and testing (CVCT), pre-exposure prophylaxis (PrEP), homosexuality, male, South Africa
Medical subject headings
Homosexuality

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Condom choicesBehavioural

    Men will receive the condom package that includes an assortment of styles, sizes, features and colors at their baseline visit, and will be able to get more condoms for free at any time after that visit by coming to a study clinic during clinic hours, or during a scheduled study visit.

  • Condom-compatible lubricant choicesBehavioural

    Men will receive condom-compatible lubricant that will include different types of lubricant (e.g., silicone-based) and different packaging (individual sachets or flat, discreet packages) at their baseline study visit, and participants will be able to access enhanced condom-compatible lubricant at any time after that visit by coming to a study clinic during clinic hours, or during a scheduled study visit.

  • Couples HIV counseling and testing (CVCT)Behavioural

    Participants will be invited to schedule couples voluntary HIV counseling and testing (CVCT) appointments with a clinic counselor at any point after they complete their baseline study visit.

  • Pre-exposure prophylaxis with FTC/TDFDrug

    Also called PrEP

    For men who meet eligibility criteria, PrEP with Emtricitabine/Tenofovir Disoproxil Fumarate (FTC/TDF) will be made available beginning one month into the study. Men who express interest and meet eligibility criteria at their baseline visit can initiate PrEP at 1 month if they test negative for HIV. For men with extenuating circumstances, whose risk profile changes, of those who become more comfortable with the PrEP intervention through enrollment in the study, PrEP will be available to initiate at the 4 month visit. Men who accept PrEP will be required to have clinic visits, in addition to the regularly scheduled study visits, one month after starting PrEP and at least every 3 months afterward to monitor blood creatinine, AST/ALT and phosphorus levels.

  • Staff and provider MSM and LGBT sensitization trainingOther

    The training for clinicians will focus on specific sexual health issues for MSM, including taking sexual histories in a non-judgmental way, physical examination techniques including anal examinations, and collection of rectal swabs for STI testing. Trainings will include topics about stigma, sexual identity and coming out, anal sex, STIs, and mental health. Training on LGBT sensitization will be provided for medical providers and staff in target clinics.

  • HIV Testing and Risk-reduction counselingBehavioural

    Risk-reduction counseling will be provided to all men at baseline and additionally at 3, 6, and 12 month visits, with an additional counseling session for men on PrEP at their initiation visit (either month 1 or 4), their 1-month follow-up visit (either month 2 or 5) and at their 9 month visit. Risk reduction counseling will be client-centered counseling, according to CDC's Fundamentals of HIV Prevention Counseling protocol.

  • Linkage to careBehavioural

    Men will be linked to needed services including HIV care and treatment for positives identified at baseline or during the study, including antiretroviral medications, and mental health services. At the end of their baseline visit, participants will receive service referral handouts for HIV care and treatment, mental health services, and other resources, as appropriate. Men who test positive for STIs will be treated at the clinic site.

Study groups in NCT02043015
Study groupRoleWhat they receive
Comprehensive HIV prevention servicesOtherA comprehensive package of HIV prevention services, including condom choices, Condom-compatible lubricant choices, Couples HIV counseling and testing (CVCT), Staff and provider MSM and LGBT sensitization training, HIV Testing and Risk-reduction counseling, Linkage to care, Pre-exposure prophylaxis with FTC/TDF
Receives: Behavioral: Condom choices; Behavioral: Condom-compatible lubricant choices; Behavioral: Couples HIV counseling and testing (CVCT); Drug: Pre-exposure prophylaxis with FTC/TDF; Other: Staff and provider MSM and LGBT sensitization training; Behavioral: HIV Testing and Risk-reduction counseling; Behavioral: Linkage to care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Retention in the Cohort

    The ability of the study to retain participants for full study period was assessed. Retention was measured by the number and percentage of enrolled participants attending study visits through the 12-month study period.

    Measured: 12 months

  2. Use of PrEP

    Uptake of PrEP by study participants was measured as the number and percentage of enrolled participants eligible for PrEP at the baseline and 3-month study visits who choose to initiate PrEP at a visit one month later.

    Measured: 4 months

  3. Number of Participants With New HIV Infection

    Incident HIV infection is measured as the number of seroconversions during follow-up among those who are HIV-uninfected at baseline.

    Measured: 12 months

Secondary outcomes (7)
  1. Condom Use

    Condom use is measured as the number of male anal sex partners that the study participant always used condoms with in the prior three or six months, as self-reported reported in the questionnaire at each study visit.

    Measured: Months 3, 6, and 12

  2. Lubricant Use

    Measured as the number and percentage of participants who used condom-compatible lubricant during their most recent anal sex act, among those who also used a condom at their most recent anal sex act.

    Measured: Months 3, 6, and 12

  3. Voluntary Counseling and Testing (VCT) and Couples Voluntary Counseling and Testing (CVCT) Uptake

    VCT and CVCT is measured as the number and percentage of participants who completed VCT in the study period as part of the study visits and the number and percentage of participants who self-reported VCT outside of their study visits. These are compared to the number and percentage of participants who self-reported having VCT in the year prior at baseline. CVCT is measured as the number and percentage of participants who completed a CVCT session as part of the study.

    Measured: 12 months

  4. Number of HIV Tests During Study

    The number of HIV tests per participant administered during the study period.

    Measured: 12 months

  5. Serodiscordant Unprotected Anal Intercourse (UAI)

    Measured as any self-reported unprotected anal intercourse in the last three or six months with a partner of opposite or unknown HIV status, as self-reported in the questionnaire at each study visit.

    Measured: Month 3, 6, and 12

  6. Acceptability of Post-exposure Prophylaxis (PEP)

    Measured as the number of men who report an eligible exposure who accept and initiate PEP.

    Measured: 12 months

  7. Acceptability of Provider Training

    Measured as the number of providers who accept the training related to MSM-specific healthcare.

    Measured: 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Jan 2014 (estimated)
  2. Study startFeb 2015
  3. Primary completionOct 2016
  4. Study completionMar 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
100 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02043015
Sponsor's protocol ID
IRB00054863
Other IDs
MP3-1R01A1094575
Status last verified
Sep 2018
First submitted
21 Jan 2014
Last updated
17 Sep 2018
Data monitoring committee
No

Publications

  • McNaghten A, Kearns R, Siegler AJ, Phaswana-Mafuya N, Bekker LG, Stephenson R, Baral SD, Brookmeyer R, Yah CS, Lambert AJ, Brown B, Rosenberg E, Blalock Tharp M, de Voux A, Beyrer C, Sullivan PS. Sibanye Methods for Prevention Packages Program Project Protocol: Pilot Study of HIV Prevention Interventions for Men Who Have Sex With Men in South Africa. JMIR Res Protoc. 2014 Oct 16;3(4):e55. doi: 10.2196/resprot.3737.

    PubMed 25325296

Questions about this trial

What is this clinical trial studying?

A study testing Condom choices, Condom-compatible lubricant choices and Couples HIV counseling and testing (CVCT) in people with HIV, run by Emory University at 3 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 38 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 17 Sep 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States, South Africa. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 17 Jan 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Retention in the Cohort (time frame: 12 months). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02043015, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Sep 2018; AzTrials last refreshed its copy on 7 Nov 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in