HIV Prevention Clinical Trial
Official title:
A Pilot Demonstration Project to Operationalize Pre-exposure Prophylaxis as Part of Combination HIV Prevention Among Men Who Have Sex With Men (MSM) and Transgender Women in Los Angeles County
The purpose of this study is to evaluate the safety, acceptability and feasibility of delivery of Pre-Exposure Prophylaxis (PrEP) or Post-Exposure Prophylaxis) PEP as part of combination HIV prevention services for high-risk MSM and transgender women.
Two community-based sites (LALGBT Center and The OASIS Clinic) will serve as facilities at
which participants may present for screening for prevention services. At the sites,
eligibility criteria will be assessed, HIV, Sexually Transmitted Disease (STD) and laboratory
testing will be performed, and HIV prevention service referrals will be initiated. Follow-up
will be on a monthly basis for the first three months, and then de-escalated to an
every-3-month interval.
The program stratifies participants into two cohorts on the basis of sexual risk behavior: a
low-moderate risk cohort (LM) and a high-risk cohort (H). Participants in the LM cohort will
be provided a customized prevention package (CPP) including access to PEP for emergency HIV
prevention in the event of unanticipated HIV exposure. Participants in the H cohort will be
provided a CPP including daily Truvada-based PrEP. All participants will be followed for 48
weeks. Participants in the LM cohort who, on longitudinal sexual risk behavior surveillance,
report increased levels of sexual risk-taking such that they meet enrollment criteria for the
H-cohort will be transitioned to the H-cohort.
At each follow-up visit, a careful safety assessment will be made, including signs/symptoms
and laboratory assessments. STD testing will be performed at 3 month intervals. An
escalating-intensity adherence intervention will be implemented based on real-time plasma
tenofovir levels. A computer-assisted self-interview (CASI) will be used to capture detailed
sexual risk, adherence, and substance use behavior.
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