IMplementation of CAB+RPV LA for People With HIV in Non-Metropolitan Areas

NCT ID: NCT06451341

Last Updated: 2025-12-03

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

RECRUITING

Total Enrollment

55 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-07-01

Study Completion Date

2027-04-30

Brief Summary

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The goal of this implementation science study is to learn about the experience of receiving and providing cabotegravir + rilpivirine long-acting (CAB+RPV LA) injections as treatment for human immunodeficiency virus (HIV) for people who live a significant distance from an HIV provider. The main questions it aims to answer are:

* Is CAB+RPV LA feasible and acceptable to patients and staff?
* What barriers and supports exist and have the most impact on receiving and providing CAB+RPV LA?
* How does CAB+RPV LA affect HIV stigma, treatment satisfaction, medication adherence and viral suppression?

People living with HIV who reside outside of the Omaha, Nebraska metro area and are starting CAB+RPV LA as part of regular medical care for HIV will be invited to participate in this study which involves completing questionnaires and an interview over 15 months. Clinic staff who are involved in providing HIV care and CAB+RPV LA will also provide input through questionnaires and an interview.

Detailed Description

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The UNMC Specialty Care Center (SCC) in Omaha, Nebraska is the only dedicated HIV care facility in the region and serves patients from across the state of Nebraska as well as southwest Iowa. It also provides the sole comprehensive CAB+RPV LA program in the area with highly trained staff, established protocols and workflows for drug acquisition, and more than 75 patients receiving CAB+RPV LA to date.

Although individuals who have transitioned to this new treatment modality report many benefits, including relief at not taking a daily pill (often seen as an unwanted daily reminder of HIV infection), some individuals still face barriers to access this treatment, which must be administered in a medical facility on a monthly or every two month dosing schedule.

For the patients of the UNMC Specialty Care Center (SCC) who live in 79 rural counties in central and eastern Nebraska and 11 counties in Southwest Iowa, some extra barriers might include transportation, bad weather, time away from work to travel, and privacy concerns surrounding receipt of injections. In an effort to improve access, the SCC has partnered with the Nebraska Medicine Internal Medicine Clinic in Grand Island, Nebraska (a rural facility located approximately 150 miles from Omaha) to provide a satellite location for patients to receive CAB+RPV LA injections.

The IM-CAPABLE study aims to evaluate this partnership and the best ways to provide CAB+RPV LA to patients who live a significant distance from an HIV provider and/or live in rural areas. People living with HIV who reside outside of the Omaha, Nebraska metro area and are starting CAB+RPV LA as part of regular medical care for HIV will be invited to participate in this study which involves completing questionnaires and an interview over 15 months. Clinic staff who are involved in providing HIV care and CAB+RPV LA will also provide input through questionnaires and an interview.

Conditions

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HIV

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Participants

Participants receiving care at the University of Nebraska Medical Center (UNMC) Specialty Care Center who live outside of the Omaha metropolitan area and who choose to start CAB+RPV LA as part of clinical care.

Acceptability of Intervention Measure (AIM)

Intervention Type BEHAVIORAL

The Acceptability of Intervention Measure (AIM) questionnaire will be administered at Baseline, Month 7 and Month 15 to patient and staff participants. This is a four-item validated measure of implementation outcomes that is often considered a "leading indicator" of implementation success.

The AIM will measure the extent to which participants believe CAB+RPV LA implementation is acceptable.

Intervention Appropriateness Measure (IAM)

Intervention Type BEHAVIORAL

The Intervention Appropriateness Measure (IAM) questionnaire will be administered at Baseline to patient and staff participants. This is a four-item validated measure of implementation outcomes that is often considered a "leading indicator" of implementation success.

The IAM will measure the extent to which participants believe CAB+RPV LA implementation is appropriate.

Feasibility of Intervention Measure (FIM)

Intervention Type BEHAVIORAL

The Feasibility of Intervention Measure (FIM) questionnaire will be administered at Baseline, Month 7 and Month 15 to patient and staff participants. This is a four-item validated measure of implementation outcomes that is often considered a "leading indicator" of implementation success.

The FIM will measure the extent to which participants believe CAB+RPV LA implementation is feasible.

HIV Stigma Scale Questionnaire

Intervention Type BEHAVIORAL

The HIV Stigma Scale Questionnaire used in this study is a shortened version of the validated 40-item HIV stigma scale. This 12-item questionnaire measures the same four stigma subscales measured in the original version, for a streamlined approach to collecting this data on personalized stigma, disclosure concerns, concerns with public attitudes and negative self-image.

This will be administered at Baseline, Month 7 and Month 15.

HIV Treatment Satisfaction Questionnaire status version (HIVTSQs12)

Intervention Type BEHAVIORAL

The HIV Treatment Satisfaction Questionnaire was developed to evaluate treatments for HIV and patient satisfaction. The original 10 item HIVTSQ, which underwent two stages of psychometric validation, has been adapted to include questions regarding injectable treatment for HIV.

Two versions of the HIVTSQ are being used. The status version (HIVTSQs12) will assess change in treatment satisfaction over time, and the change version (HIVTSQc12) will assess the change in treatment satisfaction between a patient participant's previous and current treatment.

The status version will be administered at Baseline, Month 7 and Month 15.

HIV Treatment Satisfaction Questionnaire change version (HIVTSQc12)

Intervention Type BEHAVIORAL

The HIV Treatment Satisfaction Questionnaire was developed to evaluate treatments for HIV and patient satisfaction. The original 10 item HIVTSQ, which underwent two stages of psychometric validation, has been adapted to include questions regarding injectable treatment for HIV.

Two versions of the HIVTSQ are being used. The status version (HIVTSQs12) will assess change in treatment satisfaction over time, and the change version (HIVTSQc12) will assess the change in treatment satisfaction between a patient participant's previous and current treatment.

The change version will be administered at Month 15.

Needs and Barriers Assessment

Intervention Type BEHAVIORAL

The Needs and Barriers Assessment is a questionnaire designed to assess patient participant barriers and social determinants of health, emotional challenges related to antiretroviral therapy, and the impact of switching to CAB+RPV LA treatment.

This will be administered at Baseline, Month 7 and Month 15.

Pre-visit Outreach

Intervention Type BEHAVIORAL

Patient participants will be contacted prior to each clinical injection visit for an appointment reminder and a needs assessment.

Qualitative interview

Intervention Type BEHAVIORAL

Qualitative interviews will be conducted within thirty days after study completion at Month 15 to further evaluate the participant's experience with the implementation of CAB+RPV LA treatment.

Staff

Staff at the University of Nebraska Medical Center (UNMC) Specialty Care Center or the Nebraska Medicine Grand Island clinic who provide HIV-related care and are involved in this study.

Acceptability of Intervention Measure (AIM)

Intervention Type BEHAVIORAL

The Acceptability of Intervention Measure (AIM) questionnaire will be administered at Baseline, Month 7 and Month 15 to patient and staff participants. This is a four-item validated measure of implementation outcomes that is often considered a "leading indicator" of implementation success.

The AIM will measure the extent to which participants believe CAB+RPV LA implementation is acceptable.

Intervention Appropriateness Measure (IAM)

Intervention Type BEHAVIORAL

The Intervention Appropriateness Measure (IAM) questionnaire will be administered at Baseline to patient and staff participants. This is a four-item validated measure of implementation outcomes that is often considered a "leading indicator" of implementation success.

The IAM will measure the extent to which participants believe CAB+RPV LA implementation is appropriate.

Feasibility of Intervention Measure (FIM)

Intervention Type BEHAVIORAL

The Feasibility of Intervention Measure (FIM) questionnaire will be administered at Baseline, Month 7 and Month 15 to patient and staff participants. This is a four-item validated measure of implementation outcomes that is often considered a "leading indicator" of implementation success.

The FIM will measure the extent to which participants believe CAB+RPV LA implementation is feasible.

Qualitative interview

Intervention Type BEHAVIORAL

Qualitative interviews will be conducted within thirty days after study completion at Month 15 to further evaluate the participant's experience with the implementation of CAB+RPV LA treatment.

Staff education

Intervention Type BEHAVIORAL

Staff participants will participate in Extension for Community Healthcare Outcomes (Project ECHO) educational sessions with topics such as fundamentals of HIV treatment and care, HIV outcomes, delivery of antiretroviral therapies (ART) including long-acting ART, cultural sensitivity, and social determinants of health in rural areas.

Staff Month 7 and 15 Survey - Staff Burden and Engagement

Intervention Type BEHAVIORAL

The Staff Burden and Engagement survey is a questionnaire designed to assess staff participant perceptions of engagement, burden, facilitators, barriers, communication, resources and challenges related to the implementation of long-acting injectable therapy at their clinic. This will be administered at Month 7 and Month 15.

Interventions

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Acceptability of Intervention Measure (AIM)

The Acceptability of Intervention Measure (AIM) questionnaire will be administered at Baseline, Month 7 and Month 15 to patient and staff participants. This is a four-item validated measure of implementation outcomes that is often considered a "leading indicator" of implementation success.

The AIM will measure the extent to which participants believe CAB+RPV LA implementation is acceptable.

Intervention Type BEHAVIORAL

Intervention Appropriateness Measure (IAM)

The Intervention Appropriateness Measure (IAM) questionnaire will be administered at Baseline to patient and staff participants. This is a four-item validated measure of implementation outcomes that is often considered a "leading indicator" of implementation success.

The IAM will measure the extent to which participants believe CAB+RPV LA implementation is appropriate.

Intervention Type BEHAVIORAL

Feasibility of Intervention Measure (FIM)

The Feasibility of Intervention Measure (FIM) questionnaire will be administered at Baseline, Month 7 and Month 15 to patient and staff participants. This is a four-item validated measure of implementation outcomes that is often considered a "leading indicator" of implementation success.

The FIM will measure the extent to which participants believe CAB+RPV LA implementation is feasible.

Intervention Type BEHAVIORAL

HIV Stigma Scale Questionnaire

The HIV Stigma Scale Questionnaire used in this study is a shortened version of the validated 40-item HIV stigma scale. This 12-item questionnaire measures the same four stigma subscales measured in the original version, for a streamlined approach to collecting this data on personalized stigma, disclosure concerns, concerns with public attitudes and negative self-image.

This will be administered at Baseline, Month 7 and Month 15.

Intervention Type BEHAVIORAL

HIV Treatment Satisfaction Questionnaire status version (HIVTSQs12)

The HIV Treatment Satisfaction Questionnaire was developed to evaluate treatments for HIV and patient satisfaction. The original 10 item HIVTSQ, which underwent two stages of psychometric validation, has been adapted to include questions regarding injectable treatment for HIV.

Two versions of the HIVTSQ are being used. The status version (HIVTSQs12) will assess change in treatment satisfaction over time, and the change version (HIVTSQc12) will assess the change in treatment satisfaction between a patient participant's previous and current treatment.

The status version will be administered at Baseline, Month 7 and Month 15.

Intervention Type BEHAVIORAL

HIV Treatment Satisfaction Questionnaire change version (HIVTSQc12)

The HIV Treatment Satisfaction Questionnaire was developed to evaluate treatments for HIV and patient satisfaction. The original 10 item HIVTSQ, which underwent two stages of psychometric validation, has been adapted to include questions regarding injectable treatment for HIV.

Two versions of the HIVTSQ are being used. The status version (HIVTSQs12) will assess change in treatment satisfaction over time, and the change version (HIVTSQc12) will assess the change in treatment satisfaction between a patient participant's previous and current treatment.

The change version will be administered at Month 15.

Intervention Type BEHAVIORAL

Needs and Barriers Assessment

The Needs and Barriers Assessment is a questionnaire designed to assess patient participant barriers and social determinants of health, emotional challenges related to antiretroviral therapy, and the impact of switching to CAB+RPV LA treatment.

This will be administered at Baseline, Month 7 and Month 15.

Intervention Type BEHAVIORAL

Pre-visit Outreach

Patient participants will be contacted prior to each clinical injection visit for an appointment reminder and a needs assessment.

Intervention Type BEHAVIORAL

Qualitative interview

Qualitative interviews will be conducted within thirty days after study completion at Month 15 to further evaluate the participant's experience with the implementation of CAB+RPV LA treatment.

Intervention Type BEHAVIORAL

Staff education

Staff participants will participate in Extension for Community Healthcare Outcomes (Project ECHO) educational sessions with topics such as fundamentals of HIV treatment and care, HIV outcomes, delivery of antiretroviral therapies (ART) including long-acting ART, cultural sensitivity, and social determinants of health in rural areas.

Intervention Type BEHAVIORAL

Staff Month 7 and 15 Survey - Staff Burden and Engagement

The Staff Burden and Engagement survey is a questionnaire designed to assess staff participant perceptions of engagement, burden, facilitators, barriers, communication, resources and challenges related to the implementation of long-acting injectable therapy at their clinic. This will be administered at Month 7 and Month 15.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 19 years old (as per Nebraska's adult age definition) with documented HIV infection
* Receiving care for the management of HIV disease by a provider at the Nebraska Medicine/UNMC Specialty Care Center ( UNMC SCC)
* Deemed a clinically eligible candidate for CAB+RPV LA per HIV treatment guidelines and through shared medical decision-making by provider and patient
* Resides outside of the Omaha, Nebraska metropolitan area


* Age ≥ 19 years old (as per Nebraska's adult age definition)
* Staff member of the UNMC SCC or the Grand Island clinic who is providing HIV-related care to patients and has a dedicated role in the IM-CAPABLE study
* Able to provide written and/or oral feedback as outlined in the implementation method

Exclusion Criteria

* Does not meet the clinical guidelines eligibility criteria for CAB+RPV LA
* Currently receiving CAB+RPV LA
* Currently incarcerated
* Unable to give informed consent for participation
* Pregnant or planning to become pregnant during the study period
* Intends to move from their current residence to the Omaha metropolitan area or intend to move out of the Specialty Care Center service area within 12 months after enrollment
Minimum Eligible Age

19 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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ViiV Healthcare

INDUSTRY

Sponsor Role collaborator

University of Nebraska

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Nada Fadul, MD

Role: PRINCIPAL_INVESTIGATOR

University of Nebraska

Locations

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Nebraska Medicine Grand Island Clinic

Grand Island, Nebraska, United States

Site Status RECRUITING

University of Nebraska Specialty Care Center

Omaha, Nebraska, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Maureen Kubat, BSN, RN

Role: CONTACT

402-559-4408

Jennifer O'Neill, BSN, RN

Role: CONTACT

402-559-4312

Facility Contacts

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Maureen Kubat, BSN, RN

Role: primary

402-559-4408

Maureen Kubat, BSN, RN

Role: primary

402-559-4408

Other Identifiers

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0277-24-EP

Identifier Type: -

Identifier Source: org_study_id

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