CClinicalTrials.gg
Status unknownNCT03436407Updated Feb 19, 2018

Evaluation of Implementation of Pre-exposure Prophylaxis (PrEP) in Norway

An observational study in Hiv, Sexually Transmitted Diseases and Mental Health Wellness 1, sponsored by Oslo University Hospital. Status unknown at 9 sites in Norway. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2018-02-19.

Sponsored by Oslo University Hospital · Observational

The sponsor has not verified this record recently (last verified Feb 2018), so the status shown — last known as Recruiting — may be out of date.
Study type
Observational
Model
Case-control
Time perspective
Prospective
Enrollment
500
Ages
18 Years and older
Sex
All
01

Study summary

Despite the significant preventive efforts to reduce HIV infections in the past decades, the incidence in MSM has plateaued at a higher level after the turn of the millennium. In 2015 a reduction in newly diagnosed HIV cases was reported for the first time. Early detection of HIV and treatment as prevention may have played a positive role in reducing HIV transmission, however, numbers increased again in 2016. Over 90% of HIV positive MSM in Norway are treated and virologically suppressed and thereby considered not infectious.

Since the early days of the HIV epidemic, changes in sexual behaviour and increased use of condoms have been advocated and the only tools available to prevent HIV transmission. Later, frequent testing and treatment of STIs (including HIV) have been added to the preventive measures available. Still, this does not seem to be sufficient for all MSM. The use of PrEP is therefore likely an important supplement to prevent HIV infections in MSM at high risk for HIV acquisition.

The main objective of this study is to monitor the impact of PrEP on the subject's psychological and sexual health. It is also important to monitor the adherence to PrEP, development of drug resistance (in the case of undetected HIV infection at initiation of PrEP), frequency of other STIs, changes in sexual behaviour, recreational drug use and quality of life. PrEP has proven to be effective in reducing the sexual acquisition of HIV, however this requires that the medication is taken as prescribed, whilst the subject is exposed to high risk of infection.

Read the detailed description

This study is designed to evaluated implementation of PrEP treatment as a part of the general HIV preventive program in Norway. The target groups are mainly MSM and transgender persons at high risk of HIV infection, as well as other subjects at risk of HIV infection due to their sexual practices.

Objectives include assessment of the following:

  1. Assess the impact of PrEP on the sexual and psychological health of PrEP users Incidence of sexually transmitted infections (STIs) in PrEP users compared to those not taking PrEP
  2. Assessment of drug compliance
  3. Incidence of HIV seroconversion despite PrEP
  4. Frequency and development of drug resistance in subjects who HIV-seroconvert (if any)
02

Conditions studied

  • Hiv
  • Sexually Transmitted Diseases
  • Mental Health Wellness 1
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Individuals attending the clinic for PrEP assessment are either referred from other health care providers or referred by themselves (self-referral).

Those who have commenced PrEP elsewhere (abroad, purchased themselves, another provider) and attend for "PrEP follow-up" either at Olafiaklinikken or a corresponding venerological clinic/study site in Norway, may also be included in the study.

Newly diagnosed HIV positive individuals referred to the out-patient clinic of the Dept. of Infectious Diseases, OUS, will be invited to participate as controls. They will be presented with the same consent form and questionnaire on sexual and psychological health prior to the HIV diagnosis.

Inclusion criteria

  1. Male, female or transgender persons aged ≥ 18 years who are offered or have started PrEP in routine clinical practice, and 2, 3, 4, 5, 6 or 7 (below).
  2. Men who have sex with men (MSM) and transgender persons;

    1. who have had unprotected anal sex with two or more partners during the last six months and/or
    2. who have had bacterial sexually transmittable infection(s) during the last twelve months and/or
    3. who have used post-exposure prophylaxis(PEP) during the last twelve months and/or
    4. who use recreational drugs when having sex
  3. Indication for PrEP is present according to the assessment of the health care provider
  4. Men and women who are at high risk of HIV according to their sexual practices
  5. HIV-negative partner of a HIV-positive person not yet virologically suppressed by antiretroviral therapy (ART)
  6. Sex workers with inconsistent condom use
  7. Persons with inconsistent condom use with sexual partners in / from countries with a high prevalence of HIV (COHP)

Exclusion criteria

Exclusion Criteria:

  1. HIV positive subjects
  2. Subjects who cannot take Emtricitabine/tenofovir disoproxil combination tablet (FTC/TDF) due to contraindications
04

Study design

Observational model
Case-control
Time perspective
Prospective
Enrollment
500 participants (estimated)
Patient registry
No

Groups and cohorts

  • PrEP Group

    Subject offered to start PrEP treatment in routine clinical practice

  • Control Group

    1. Enrolled patients will be regarded as their own control when it comes to their sexual health and quality of life reported for period prior to inclusion in the study. 2. Subjects diagnosed with HIV within last 12 months in general clinical practice and referred to the outpatient clinic at the Dept. of Infectious Diseases, OUS. (details in protocol 3.3.2) 3. Frequency of STI reported to the National Institute of Public Health (MSIS) will be compared with the frequency of STIs in the study cohort.

05

What researchers measure

Primary outcomes

  1. Impact of PrEP

    Assess the impact of PrEP on the sexual and psychological health of PrEP users

    Time frame: 24 months

Secondary outcomes

  1. Incidence of STIs

    Incidence of sexually transmitted infections (STIs) in PrEP users compared to those not taking PrEP

    Time frame: 24 months

  2. Drug compliance

    Assessment of drug compliance

    Time frame: 24 months

  3. HIV seroconversion

    Incidence of HIV seroconversion despite PrEP

    Time frame: 24 months

  4. Drug resistance

    Frequency and development of drug resistance in subjects who HIV-seroconvert

    Time frame: 24 months

06

Study locations

3 of 9 sites recruiting
  • Helse Bergen HF - Haukeland universitetssykehus
    Bergen, Norway
    Not yet recruiting
  • Sørlandet sykehus HF
    Kristiansand, Norway
    Not yet recruiting
  • Olafia Clinic,Oslo University Hosptial
    Oslo, 0424, Norway
    • Jorge Johansen, nurse · Contact · jorgej@ous-hf.no · 23075840
    • Michelle Hanlon, MD · Contact · mihanl@ous-hf.no · 23075840
    • Anne Olaug Olsen, MD PhD · Principal investigator
    • Michelle Hanlon, MD · Sub investigator
    • Frank O Pettersen, MD PhD · Sub investigator
    Recruiting
  • Akershus universitetssykehus HF
    Oslo, Norway
    Recruiting
  • Brynsenglegene
    Oslo, Norway
    Not yet recruiting
  • Dept. Inf. Diseases, Oslo University Hospital
    Oslo, Norway
    Not yet recruiting
  • Helse Stavanger HF - Stavanger universitetssjukehus
    Stavanger, Norway
    Recruiting
  • Universitetssykehuset Nord-Norge HF
    Tromsø, Norway
    Not yet recruiting
  • Helse Midt-Norge St Olavs Hospital
    Trondheim, Norway
    Not yet recruiting
07

References and documents

Study documents

  • Statistical analysis plan · Mar 23, 2017
  • Study protocol · Jan 30, 2018
  • Informed consent form · Jan 31, 2018

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03436407
Lead sponsor
Oslo University Hospital
Responsible party
Anne Olaug Olsen (Senior consultant/Assoc Prof, Oslo University Hospital) — Principal investigator
First posted
Feb 19, 2018
Start date
Oct 25, 2017
Primary completion
Dec 31, 2020 (estimated)
Completion
Dec 31, 2020 (estimated)
Last update
Feb 19, 2018

Study contacts

Jorge Johansen
Contact
jorgej@ous-hf.no
23075840 ext. 47
Frank O Pettersen
Contact
uxpfra@ous-hf.no
22118080 ext. 47
Anne Olaug Olsen, MD PhD
principal investigator · Oslo University Hospital
View the source record on ClinicalTrials.gov ↗

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This study is status unknown, as verified in Feb 2018. You cannot join it, but the record below documents what was studied.

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