An Open Label Demonstration Project and Phase II Safety Study of Pre-Exposure Prophylaxis
Condition: HIV Infection
MeSH terms: HIV Infections
Study type: Interventional
Phase: Phase 2

Summary: 
      Approximately 200 HIV-uninfected young men who have sex with men (YMSM) at high risk of
      acquiring HIV infection, ages 18-22 years, inclusive, will be recruited across all
      participating Adolescent Medicine Trials Units (AMTU). The behavioral intervention will be
      assigned at the level of the site, which include Many Men, Many Voices (3MV) and Personalized
      Cognitive Counseling (PCC). Subjects will first complete the behavioral intervention offered
      at their respective site and then be provided with open label emtricitabine (FTC)/tenofovir
      (TDF) (Truvada®) as PrEP. Behavioral and biomedical data will be collected at baseline and 0,
      4, 8, 12, 24, 36 and 48 weeks. Any subjects who become HIV infected during the course of the
      study will be discontinued from the study agent and followed for an additional 24 weeks after
      the study visit at which HIV infection is confirmed. Those subjects who meet specific bone or
      renal criteria at the Week 48 visit or the 24-Week HIV Seropositive visit will be followed
      for an additional 48 weeks in the Extension Phase to monitor longer-term outcomes of
      potential concerns.
    

Detailed description: 
      The primary objectives of the study are to provide additional safety data regarding FTC/TDF
      (Truvada®) use as PrEP in YMSM, to examine acceptability, patterns of use, rates of
      adherence, measure levels of drug exposure and patterns of risk behavior when YMSM are
      provided open label FTC/TDF (Truvada®). The study will also examine information regarding
      safety and efficacy of FTC/TDF (Truvada®) as PrEP from prior studies.
    

Intervention name(s): 3MV; PCC; Emtricitabine/tenofovir (FTC/TDF (Truvada®))
Intervention type(s): Behavioral; Behavioral; Drug
Intervention description(s): Many Men, Many Voices (3MV) is based on Social Cognitive Theory and the Transtheoretical Model of Behavior Change. 3MV is a group-level intervention that addresses behavioral and social determinants and other factors influencing the HIV/sexually transmitted infection (STI) risk and protective behaviors of Men having sex with men (MSM) of color. The other factors include cultural, social and religious norms, racial identity and degree of connectedness to communities, HIV/STI interactions, sexual relationship dynamics, and the social influences of racism and homophobia.; Personalized Cognitive Counseling (PCC) is based on the Model of Relapse Prevention and Gold's Self-Appraisal of Risk Behavior. PCC is a 1-hour, single-session, individual level intervention administered by a trained counselor in a clinic setting. Counselors ask the client to recall and describe in as much detail, a recent encounter of unprotected anal sex with another man of unknown or sero-discordant HIV status. The client then identifies and expresses thoughts, feelings, or attitudes that might have led to the high-risk behavior. The client and counselor examine and identify thoughts that may have led the client to decide to engage in high transmission risk sex. The client and counselor agree on strategies that can be used to deal with similar situations in the future.; All subjects will be provided with daily FTC/TDF (Truvada®) as Pre-exposure prophylaxis (PrEP) for 48 weeks.
Other intervention name(s): Many Men, Many Voices; Personalized Cognitive Counseling; FTC/TDF; Truvada®; Emtricitabine/tenofovir; PrEP
Intervention MeSH terms: Tenofovir; Emtricitabine; Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: HIV, PrEP, FTC/TDF, Truvada®