HIV Clinical Trial
Official title:
Factors Affecting the Intention to Take Non-occupational HIV Post-exposure Prophylaxis Among Thai Men Who Have Sex With Men
The potential participants will be informed of the study details, including the study objectives. Once they have read the study information sheet and have a good understanding of the study, those who intend to participate in the study will be asked to sign the consent form for this study. There are 2 groups of participants: MSM who seek HIV voluntary counseling and testing service (phase I) and MSM who meet nPEP criteria (phase II).
This study design is mixed-method, starting with quantitative research and followed by
qualitative research. The study will be conducted in 2 phases: a cross-sectional study
during phase I and a prospective descriptive study during phase II, which will use
qualitative research techniques to help understand and define obstacles and uncover
opportunities to improve adherence to post-exposure prophylaxis.
During phase I, this study is a quantitative research study using a cross-sectional study
design which aims to enroll 450 men who have sex with men (MSM) within 6 months and to
collect data by administration of questionnaire amongst all MSM via face-to-face interview.
During phase II, we will use a quantitative research design and perform in-depth interviews
with those MSM who choose to receive and choose not to receive nPEP despite the fact that
they meet nPEP criteria. We expect to identify approximately 50 MSM who meet nPEP criteria
during the enrollment period. The number of volunteers will be determined based on
saturation theory in which the data collection will be considered complete after analysis of
the data shows that additional entries provide no further information (64). The number of
volunteers in phase II may not be able to be specified with certainty in advance. Enrollment
of subjects will stop once data acquisition is saturated.
An initial review of demographic data and sexual behavior amongst MSM seen at the TRC-ARC
will be undertaken by interviewing the TRC-ARC staff who are responsible for looking after
this population. This process will aid understanding of clinic logistics and help identify
opportunities to meet with MSM individuals. The potential participants will be informed of
the study details, including the study objectives. Once they have read the study information
sheet and have a good understanding of the study, those who intend to participate in the
study will be asked to sign the consent form for this study. There are 2 groups of
participants: MSM who seek HIV voluntary counseling and testing service (phase I) and MSM
who meet nPEP criteria (phase II).
Phase I. MSM who seek HIV voluntary counseling and testing
1. All MSM clients will be interviewed to complete the questionnaires designed to collect
information for this study before the pre-test counseling. The questions will collect
demographic data and data regarding HIV risk behaviors, HIV knowledge, intention to
take nPEP, factors affecting the intention to take nPEP, experience on nPEP use, and
awareness of nPEP.
2. After MSM clients receive the counseling. They will be interviewed to answer the
questionnaires about HIV knowledge, intention to take nPEP, factor affecting to
intention to take nPEP, nPEP knowledge.
3. All MSM clients will receive pre-test counseling, HIV testing, and post-test counseling
according to the standard of care at the Anonymous Clinic, TRC-ARC. Counselors will
also assess clients for nPEP eligibility criteria according to the standard clinic
guidelines.
Phase II. MSM who receive nPEP
1. Participant who describes a history of an HIV risk exposure within the preceding 72
hours and meets nPEP eligibility criteria as assessed by the clinic counselor. After
participants receive all information to know whether they receive antiretroviral
medication, they can decide by themselves about taking medication. The participant who
select to take nPEP will receive a 14-day supply of nPEP medication and will be
scheduled back to receive the rest of their medication.
2. Both participant who decide to take and not take nPEP will be asked to take part in the
in-depth interviews to examine factors affecting the decision to use nPEP.
3. At week 6, the participants who take nPEP will be evaluated for HIV infection,
adherence to medication during the 28-day course of nPEP, side effects from nPEP and
asked to be interviewed about risk behaviors and other HIV prevention methods since the
start of nPEP.
At each of these study visits, the participant will receive risk reduction counseling along
with the provision of condoms and lubricant
In accordance to the standard of care at the Anonymous Clinic, TRC-ARC, participants who
decide to take nPEP (whose risk of HIV exposure must be within the preceding 72 hours) will
receive 3 antiretroviral medications; 2 nucleoside reverse transcriptase inhibitors plus 1
protease inhibitor or non-nucleoside reverse transcriptase inhibitor. The clients will
receive HIV antibody testing prior to taking nPEP and at week 6 after starting nPEP.
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Observational Model: Case-Crossover, Time Perspective: Cross-Sectional
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