Effects of Two Anti-HIV Drug Regimens on HIV Transmission Risk Behavior Among SMART Study Participants

NCT ID: NCT00386035

Last Updated: 2014-04-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Total Enrollment

883 participants

Study Classification

OBSERVATIONAL

Study Start Date

2002-01-31

Study Completion Date

2008-09-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of this study is to compare the effects of two different anti-HIV drug regimens on HIV transmission risk behavior among SMART study participants.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

It is important to consider the role that HIV infected individuals play in ongoing HIV transmission. Different anti-HIV treatment regimens may lead to variations in HIV transmission risk behavior among HIV infected individuals. HIV infected people with viral loads of less than 1,000 copies/ml are less likely to transmit HIV through heterosexual sex. However, condom use sometimes decreases after individuals start combination antiretroviral therapy (ART); also, some studies have shown an increased rate in acquiring sexually transmitted infections (STIs) following initiation of ART, and those on ART may transmit a drug-resistant strain of HIV. In the SMART study, participants were randomly assigned to one of two treatment groups:

* Group 1 participants will follow a drug conservation (DC) regimen in which ART will be stopped or deferred until CD4 cell count drops below 250 cells/mm3, will be initiated until CD4 cell count is at least 350 cells/mm3, and then will be followed by episodic ART based on CD4 cell count.
* Group 2 participants will follow a viral suppression (VS) regimen in which ART is continued to keep viral loads as low as possible, regardless of CD4 cell count.

The purpose of this study is to compare how the DC and VS regimens affect HIV transmission risk behavior among SMART study participants.

At baseline, participants will complete a questionnaire about their sexual behavior during the previous 2 months. They will also undergo urine and blood collection for STI testing. These same procedures will occur at Months 4 and 12, then every year thereafter for the first 4 years that a participant is in the parent study. Participants and their physicians will be notified of STI testing results so that patients can be referred to appropriate care.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

HIV Infections

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

1: DC Group

HIV infected participants who will stop or defer ART until the CD4 cell count drops below 250 cells/mm3 and who discontinue ART when CD4 cell count reaches above 350 cells/mm3. Participants are followed by episodic ART based on CD4 cell count.

Delayed ART

Intervention Type DRUG

Participants follow a drug conservation (DC) regimen in which ART is stopped or deferred until CD4 cell count dropped below 250 cells/mm3, initiated until CD4 cell count is at least 350 cells/mm3, and then are followed by episodic ART based on CD4 cell count.

2: VS Group

HIV infected participants who continue ART to keep viral loads as low as possible, regardless of CD4 cell count.

Continuous ART

Intervention Type DRUG

Group 2 participants follow a viral suppression (VS) regimen in which ART was continued to keep viral loads as low as possible, regardless of CD4 cell count.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Delayed ART

Participants follow a drug conservation (DC) regimen in which ART is stopped or deferred until CD4 cell count dropped below 250 cells/mm3, initiated until CD4 cell count is at least 350 cells/mm3, and then are followed by episodic ART based on CD4 cell count.

Intervention Type DRUG

Continuous ART

Group 2 participants follow a viral suppression (VS) regimen in which ART was continued to keep viral loads as low as possible, regardless of CD4 cell count.

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Coenrollment in the SMART study
* Parent or guardian willing to provide informed consent, if applicable
Minimum Eligible Age

13 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Community Programs for Clinical Research on AIDS

NETWORK

Sponsor Role collaborator

National Institute of Allergy and Infectious Diseases (NIAID)

NIH

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Wafaa El-Sadr, MD, MPH

Role: STUDY_CHAIR

Harlem AIDS Treatment Group, Harlem Hospital Center

James Neaton, PhD

Role: STUDY_CHAIR

CPCRA Statistical and Data Management Center/CCBR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

AIDS Healthcare Foundation CRS

Beverly Hills, California, United States

Site Status

UCSF, Fresno, School of Medicine, Dept. of Internal Medicine CRS

Fresno, California, United States

Site Status

Dr. M. Estes Med. Practice CRS

Mill Valley, California, United States

Site Status

Dr. Robert Scott Med. Practice CRS

Oakland, California, United States

Site Status

East Bay AIDS Ctr. CRS

Oakland, California, United States

Site Status

Dr. Shawn Hassler Med. Practice CRS

San Francisco, California, United States

Site Status

Positive Health Program Clinic (San Francisco Gen. Hosp.) CRS

San Francisco, California, United States

Site Status

Dr. Virginia Cafaro Med. Practice CRS

San Francisco, California, United States

Site Status

Dr. William Owen Med. Practice CRS

San Francisco, California, United States

Site Status

Castro-Mission Health Ctr. CRS

San Francisco, California, United States

Site Status

San Francisco VAMC, Infectious Diseases Clinic CRS

San Francisco, California, United States

Site Status

UCSF PHP, Gen. Internal Medicine Practice CRS

San Francisco, California, United States

Site Status

Beacon Clinic at Boulder CRS

Boulder, Colorado, United States

Site Status

Denver Infectious Diseases Consultants CRS

Denver, Colorado, United States

Site Status

Kaiser Permanente of Denver CRS

Denver, Colorado, United States

Site Status

Univ. of Colorado Health Science Ctr. CRS

Denver, Colorado, United States

Site Status

Denver Public Health CRS - INSIGHT

Denver, Colorado, United States

Site Status

Denver Public Health CRS

Denver, Colorado, United States

Site Status

Eastside Family Health Ctr. CRS

Denver, Colorado, United States

Site Status

Denver VAMC CRS

Denver, Colorado, United States

Site Status

Western Infectious Disease Consultants CRS

Wheat Ridge, Colorado, United States

Site Status

Washington DC VAMC, Washington Regional AIDS Program, Infectious Diseases CRS

Washington D.C., District of Columbia, United States

Site Status

Miami VAMC CRS

Miami, Florida, United States

Site Status

Atlanta VAMC CRS

Decatur, Georgia, United States

Site Status

Harper Hosp., Detroit CRS

Detroit, Michigan, United States

Site Status

Wayne State Univ. CRS

Detroit, Michigan, United States

Site Status

Wayne State Univ. INSIGHT CRS

Detroit, Michigan, United States

Site Status

Detroit Community Health Connection, Inc. CRS

Detroit, Michigan, United States

Site Status

McAuley Health Ctr. CRS

Grand Rapids, Michigan, United States

Site Status

Cooper Univ. Hosp. CRS

Camden, New Jersey, United States

Site Status

Cooper Hospital/Univ. Med. Ctr., The Cooper Early Intervention Program (EIP) CRS

Camden, New Jersey, United States

Site Status

New Jersey Medical School- Adult Clinical Research Ctr. CRS

Newark, New Jersey, United States

Site Status

South Jersey Infectious Disease, Cape Clinical Trials CRS

Somers Point, New Jersey, United States

Site Status

The Early Intervention Program at Kennedy Hosp. CRS

Voorhees Township, New Jersey, United States

Site Status

St. Vincent Hosp. & Med. Ctr. CRS

New York, New York, United States

Site Status

Bronx Prevention Center CRS

The Bronx, New York, United States

Site Status

Bronx-Lebanon Hosp. Ctr. CRS

The Bronx, New York, United States

Site Status

Montefiore Med. Ctr., AIDS Ctr. CRS

The Bronx, New York, United States

Site Status

PeaceHealth Med. Group - Hilyard Street Clinic CRS

Eugene, Oregon, United States

Site Status

Multnomah County Health Dept., HIV Health Services Ctr. CRS

Portland, Oregon, United States

Site Status

Legacy Clinic Good Samaritan CRS

Portland, Oregon, United States

Site Status

The Research & Education Group-Portland CRS

Portland, Oregon, United States

Site Status

Providence Portland Med. Ctr., Ambulatory Care and Education Ctr. CRS

Portland, Oregon, United States

Site Status

Kaiser Immune Deficiency Clinic of Portland CRS

Portland, Oregon, United States

Site Status

Legacy Clinic Emanuel CRS

Portland, Oregon, United States

Site Status

Oregon Health & Sciences Univ. Internal Medicine (L-475) CRS

Portland, Oregon, United States

Site Status

Philadelphia FIGHT - Dr. Jay Kostman CRS

Philadelphia, Pennsylvania, United States

Site Status

Temple Univ. School of Medicine CRS

Philadelphia, Pennsylvania, United States

Site Status

Albert Einstein Med. Ctr., Immunodeficiency Ctr. CRS

Philadelphia, Pennsylvania, United States

Site Status

MediCorp, Infectious Disease Associates CRS

Fredericksburg, Virginia, United States

Site Status

Hanover Med. Park (Mechanicsville, VA) CRS

Mechanicsville, Virginia, United States

Site Status

Eastern Virginia Med. School, Ctr. for the Comprehensive Care of Immune Deficiency CRS

Norfolk, Virginia, United States

Site Status

Petersburg Health Care Alliance CRS

Petersburg, Virginia, United States

Site Status

Vernon Harris East End Community Health Ctr. CRS

Richmond, Virginia, United States

Site Status

CrossOver Health Ctr. CRS

Richmond, Virginia, United States

Site Status

South Richmond Health Care Ctr. CRS

Richmond, Virginia, United States

Site Status

Hunter Holmes McGuire VAMC CRS

Richmond, Virginia, United States

Site Status

VCU Health Systems, Infectious Disease Clinic CRS

Richmond, Virginia, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Bunnell R, Ekwaru JP, Solberg P, Wamai N, Bikaako-Kajura W, Were W, Coutinho A, Liechty C, Madraa E, Rutherford G, Mermin J. Changes in sexual behavior and risk of HIV transmission after antiretroviral therapy and prevention interventions in rural Uganda. AIDS. 2006 Jan 2;20(1):85-92. doi: 10.1097/01.aids.0000196566.40702.28.

Reference Type BACKGROUND
PMID: 16327323 (View on PubMed)

Kozal MJ, Amico KR, Chiarella J, Schreibman T, Cornman D, Fisher W, Fisher J, Friedland G. Antiretroviral resistance and high-risk transmission behavior among HIV-positive patients in clinical care. AIDS. 2004 Nov 5;18(16):2185-9. doi: 10.1097/00002030-200411050-00011.

Reference Type BACKGROUND
PMID: 15577652 (View on PubMed)

Remien RH, Halkitis PN, O'Leary A, Wolitski RJ, Gomez CA. Risk Perception and sexual risk behaviors among HIV-positive men on antiretroviral therapy. AIDS Behav. 2005 Jun;9(2):167-76. doi: 10.1007/s10461-005-3898-7.

Reference Type BACKGROUND
PMID: 15933836 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

http://clinicaltrials.gov/show/NCT00027352

Click here for more information on CPCRA 065

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

SMART

Identifier Type: -

Identifier Source: secondary_id

10113

Identifier Type: REGISTRY

Identifier Source: secondary_id

CPCRA 065B

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.