Partners PrEP Program

HIV Infections Clinical Trial

— PPP  

Official title:

Integrated PrEP and ART Delivered in Ugandan Public Health Clinics to Improve HIV and ART Outcomes for HIV Serodiscordant Couples

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03586128
• Other study ID #: STUDY00000320
• Status: Completed
• Start date: June 8, 2018
• Est. completion date: November 19, 2021

Study information

• Verified date: December 2021
• Source: University of Washington
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Through close collaboration with the Ugandan Ministry of Health, the investigators plan to provide PrEP for HIV-negative members of HIV serodiscordant couples by launching PrEP delivery within 12 public ART clinics in Kampala, Uganda. Intervention delivery will be launched in a staggered fashion among clinics through a stepped wedge cluster randomized trial providing a rigorous research opportunity to measure the effect of the intervention on PrEP and ART initiation and adherence. To measure these outcomes using clinic records and biomarkers, the program will enroll approximately 1440 HIV serodiscordant couples. Additionally, the program will collect qualitative and quantitative data to determine if PrEP-taking is a modeled behavior that facilitates ART use and characterize the way that PrEP and ART use interact within couples and estimate the programmatic costs of the integrated PrEP and ART strategy.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1381
• Est. completion date: November 19, 2021
• Est. primary completion date: November 19, 2021
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

For both members of the couple

• Age =18 years
• Able and willing to provide informed consent
• Sexually active with each other
• Willing to engage with the clinic system as a couple For HIV-positive members of the couples (index participants)
• HIV-positive, according to national HIV testing algorithm
• Recent diagnosis as a member in an HIV serodiscordant couple
• Not currently enrolled in an HIV treatment clinical trial For HIV-negative members of the couples (partner participants)
• HIV-negative, according to national HIV testing algorithm
• Recent diagnosis as a member in an HIV serodiscordant couple
• Not currently enrolled in an HIV treatment clinical trial
• Not currently using PrEP
• Eligible for PrEP, according to WHO or Ugandan national guidelines

Exclusion Criteria:

• Otherwise not eligible based on the above inclusion criteria

Related Conditions & MeSH terms

• HIV Infections

Intervention

Drug:
• PrEP
PrEP will be introduced into clinics according to Uganda national guidelines using a stepped wedge design. Uganda guidelines recommend any tenofovir disoproxil fumarate (TDF) containing medication be used for PrEP; this includes emtricitabine (FTC)/TDF, lamivudine (3TC)/TDF or TDF alone.
• ART
ART medication will be provided according to Uganda national guidelines for persons living with HIV.

Locations

Country	Name	City	State
Uganda	Makerere University	Kampala

Sponsors (3)

Lead Sponsor	Collaborator
University of Washington	Harvard University, Makerere University

Country where clinical trial is conducted

Uganda, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of HIV-positive members of a discordant partnership who initiate ART	Measure ART initiation of the HIV-positive member of the couple	Up to 24 months
Primary	HIV viral load suppression of HIV-positive members of a discordant partnership	ART adherence by measuring HIV viral load of the HIV-positive member of the couple	Up to 24 months
Primary	Number of HIV-negative members of a discordant partnership who initiate PrEP	Measure PrEP initiation of the HIV-negative member of the couple	Up to 24 months
Primary	PrEP adherence of HIV-negative members of a discordant partnership	Measure PrEP adherence, among HIV-negative members of a discordant partnership who initiated PrEP, by self-report and tenofovir drug level testing.	Up to 24 months
Secondary	PrEP-taking as a modeled behavior	Measure the degree to which PrEP-taking behavior is modeled by HIV-negative partners and the degree to which it is witnessed by HIV-positive partners using questionnaires developed for this purpose.	Up to 24 months
Secondary	Facilitators and barriers to use of ART and PrEP	Mixed methods assessment of how integrated PrEP and ART is 1) used among couples and 2) implemented by health care providers using qualitative interviews and questionnaires. These data will be aggregated to understand the facilitators and barriers to use of ART and PrEP.	Up to 24 months
Secondary	Programmatic costs of providing integrated PrEP and ART to HIV serodiscordant couples	Conduct micro-costing, cost-effectiveness, and budget impact analyses to estimate the programmatic costs of providing integrated PrEP and ART to HIV serodiscordant couples.	Up to 24 months