PrEP Restart for Adolescent Girls and Young Women Using STI Self Testing and Assessment of Risk

NCT ID: NCT06030856

Last Updated: 2023-09-11

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

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-07-05

Study Completion Date

2024-08-31

Brief Summary

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This is a pilot randomized trial among 50 AGYW (aged ≥16≤18 years), who discontinued PrEP use within the past 6 months, assigned in a 1:1 ratio to receive: 1) STI self-test kits (Neisseria gonorrhoea (NG), Chlamydia trachomatis (CT) and Trichomonas vaginalis (TV)) with in-person instruction at enrolment and telephone/video-based instructions for home use coupled with self-administered behavioural risk assessment or 2) self-administered behavioural risk assessment only (standard of care). All participants will receive comprehensive sexual and reproductive health (SRH) services during their study visits including choice of family planning method initiation and support, and behavioural HIV/STI risk reduction counselling.

Detailed Description

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The PALESA study aims to determine the feasibility of conducting a randomized controlled trial (RCT) to determine the impact of decentralized sexually transmitted infection (STI) point of care (POC) self-testing and risk self-assessment interventions to trigger pre-exposure prophylaxis (PrEP) re-start among adolescent girls and young women (AGYW) in South Africa at potential ongoing risk of re- acquiring STIs and HIV.

This overall study comprises two components that include a formative research study enrolling \~60 participants for qualitative in-depth interviews (IDIs) (this has been completed) and a prospective cohort study (Pilot randomized controlled trial - RCT) enrolling 50 AGYW with both clinical, diagnostic laboratory and nested qualitative methodologies.

The RCT seeks to establish the feasibility of conducting a randomized controlled trial among AGYW in South Africa to determine the impact of decentralized or at-home STI testing \[(for Neisseria gonorrhea (NG), Chlamydia trachomatis (CT) and Trichomonas vaginalis (TV)\] on restarting PrEP relative to a self-administered behavioural risk assessment. Additionally qualitative interviews will be conducted to assess adolescent girls experiences of at-home STI testing, behavioural risk assessment, and re-starting PrEP while participating in the pilot trial through exit interviews.

Objective 1: To determine the feasibility and acceptability of conducting a RCT among South African AGYW to determine the impact of STI self-testing coupled with a self-administered behavioural risk assessment on restarting PrEP relative to a self-administered behavioural risk assessment only

Objective 2: To assess AGYW acceptability of and experiences with use at-home STI testing, self-administered behavioural risk assessment, and re-starting PrEP while participating in the pilot RCT

Conditions

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HIV Prevention

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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STI test kits for home use coupled with self-administered behavioural risk assessment

The adolescent will receive STI test kits (NG, CT and TV) for home use coupled with self-administered behavioural risk assessment at the screening and enrolment visit.

Group Type EXPERIMENTAL

STI test kits (NG, CT and TV) for home use

Intervention Type DEVICE

The adolescent randomized to the at-home STI testing arm will be provided with in-person instruction at enrollment and flyers (in English and isiZulu) with printed step-by-step instructions for kit use. Information will include details on how to store the kits, criteria for adequate specimen collection and preparation, how to run the test, and how to interpret the test results. Video-based instructions with accompanying text subtitles and audio options may also be provided for home use.

Self Administered Behavioural Risk Assessment

Intervention Type BEHAVIORAL

Self Administered assessment to determine risk of HIV, STIs and pregnancy

Self-administered behavioural risk assessment only (standard of care)

The adolescent will receive a self-administered behavioural risk assessment at the screening and enrolment visit

Group Type ACTIVE_COMPARATOR

Self Administered Behavioural Risk Assessment

Intervention Type BEHAVIORAL

Self Administered assessment to determine risk of HIV, STIs and pregnancy

Interventions

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STI test kits (NG, CT and TV) for home use

The adolescent randomized to the at-home STI testing arm will be provided with in-person instruction at enrollment and flyers (in English and isiZulu) with printed step-by-step instructions for kit use. Information will include details on how to store the kits, criteria for adequate specimen collection and preparation, how to run the test, and how to interpret the test results. Video-based instructions with accompanying text subtitles and audio options may also be provided for home use.

Intervention Type DEVICE

Self Administered Behavioural Risk Assessment

Self Administered assessment to determine risk of HIV, STIs and pregnancy

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* For the full cohort, all participants must:

* Be cis-gender adolescent females (16-20 years of age)
* Be literate
* Currently sexually active
* Be willing to participate in in-person and virtual study visits
* Not be pregnant or planning to be pregnant for the next 6 months
* Be HIV-negative but not ready to initiate PrEP at the screening and enrolment visit
* Have used PrEP with subsequent discontinuation within the last 6 months
* Have no contraindications to oral PrEP per self-report
* Have no indication of possible acute HIV infection, according to South African PrEP guidelines
* Have their own personal smart phone
* Willing to provide written informed consent/assent to participate in this study

For the subset invited to qualitative interviews, all participants must be:

• Willing to participate in an IDI at/before their month 6 visit (study exit visit)

Exclusion Criteria

* Potential AGYW participants who meet any of the following criteria will be excluded from the study:

* At Screening and Enrollment, parent/guardian (for those participants \<18 years) is unwilling to provide written informed consent
* At Screening and Enrollment, is already participating in another research study involving drugs, medical devices, or vaccines for STI prevention or treatment.
* Is not willing to comply with study procedures
* As determined by the PIs/designee, any current or historical physical health, mental health or social issue or condition that the site investigator or designee determines should exclude participation.
* Has any other condition that, in the opinion of the PIs/designee, would preclude informed consent, make study participation unsafe, or otherwise interfere with achieving the study objectives.
Minimum Eligible Age

16 Years

Maximum Eligible Age

20 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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University of Alabama at Birmingham

OTHER

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role collaborator

Wits RHI Research Centre Clinical Research Site

OTHER

Sponsor Role lead

Responsible Party

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Thesla Palanee-Phillips

Director:Clinical Trials

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Wits RHI Research Centre

Hillbrow, Gauteng, South Africa

Site Status RECRUITING

Countries

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South Africa

Central Contacts

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Thesla Palanee-Phillips

Role: CONTACT

11 358 5471 ext. +27

Krishnaveni Reddy

Role: CONTACT

11 358 5470 ext. +27

Facility Contacts

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Thesla Palanee-Phillips

Role: primary

11 358 5471 ext. +27

Krishnaveni Reddy

Role: backup

11 358 5470 ext. +27

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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PALESA

Identifier Type: -

Identifier Source: org_study_id

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