Phase 2
N=536
The ADAPT Study: Use of Emtricitabine and Tenofovir Disoproxil Fumarate for Pre-Exposure Prophylaxis (PrEP)
HIV Infections
Bottom Line
View on ClinicalTrials.gov: NCT01327651 ↗Enrolled (actual)
536
Serious AEs
4.1%
Results posted
May 2017
Primary outcome: Primary: Proportion of Sexual Exposures Covered by Pre- and Post-exposure Dosing — 75; 56; 52; 85 percentage of sexual exposures
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Daily dosing (Drug); Time-driven dosing (Drug); Event-driven dosing (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- HIV Prevention Trials Network
- Primary completion
- Dec 2014
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Proportion of Sexual Exposures Covered by Pre- and Post-exposure Dosing |
75; 56; 52; 85; 84; 74 | — |
| PRIMARY The (Minimum) Total Number of Pills Needed for 100% Coverage Over the Follow-up Period (Based on Randomization Arm and Self-reported Sexual History in the Weekly Interviews) |
2097; 1552; 1906; 1746; 1573; 1268 | — |
| PRIMARY The Total Pills Actually Used Over the Follow-up Period |
7349; 2852; 2000; 8285; 3713; 2157 | — |
| PRIMARY Self-reported Side Effect or Symptom Scores |
12.4; 6.0; 7.8; 14.2; 14.3; 13.3 | — |
| SECONDARY Measurement of TFV-DP (Tenofovir Diphosphate) in PBMC (Peripheral Blood Mononuclear Cell) |
33; 16; 25; 31; 29; 30 | — |
| SECONDARY A Listing of Adverse Events (AEs) by Grade, Relationship to Study Product, and Arm |
0; 2; 0; 0; 0; 0 | — |
| SECONDARY A Listing, by Arm, of Drug Resistance Test Results and Plasma HIV RNA Levels Among All Participants Who Seroconvert While on Study |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY The Percentage of Correctly Timed Adherence (Number of Pills Taken Within the Recommended Time Frame/Number of Pills Recommended) During 24 Weeks of Follow-up Based on Weekly Interviews and Adjusted EDM (Electronic Drug Monitoring) Data |
75; 65; 53; 85; 79; 65 | — |
| SECONDARY The Proportion of Participants Who Discontinue All PrEP Use Based on Self-report Via CASI or Weekly Interviews |
0; 0; 1; 0; 0; 0 | — |
| SECONDARY A Listing of Adverse Events (AEs) by Grade, Relationship to Study Product, and Arm |
0; 2; 0; 0; 0; 0 | — |
| SECONDARY A Listing, by Arm, of Drug Resistance Test Results and Plasma HIV RNA Levels Among All Participants Who Seroconvert While on Study |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY A Listing, by Arm, of Drug Resistance Test Results and Plasma HIV RNA Levels Among All Participants Who Seroconvert While on Study |
0; 0; 0; 0; 0; 0 | — |
Summary
Pre-exposure prophylaxis (PrEP) is a method of preventing HIV infection through the use of antiretroviral (ARV) medications before exposure to HIV. This study will examine the feasibility of different methods of dosing for a PrEP regimen. Three methods of delivery will be compared: daily, time-based, and event-based.
Eligibility Criteria
Inclusion Criteria
- Literacy in one of the study languages (Thai, Xhosa, and/or English)
- Able to provide written informed consent
- Able to provide weekly telephonic updates
- Within 70 days of enrollment:
- Serum creatinine less than or equal to the upper limit of normal (ULN) and calculated creatinine clearance of at least 70 mL/min by the Cockcroft-Gault formula. More information on this criterion can be found in the protocol.
- Serum phosphate greater than or equal to the lower limit of normal (LLN)
- Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) less than or equal to 2 times ULN
- Hemoglobin greater than 10 g/dL
- Hepatitis B surface antigen (HBsAg)-negative
- Willing and able to provide adequate locator information
Inclusion Criteria for MSM/TGW:
- Male at birth
- Reporting anal intercourse and/or receptive neovaginal intercourse with at least one man or transgender woman in the past 6 months
- One or more of the following risk factors for HIV acquisition in the past 6 months according to self-report: sexual intercourse with more than one man or transgender woman; history of an acute sexually transmitted infection (STI); sex in exchange for money, goods, or favors; condomless intercourse (oral, anal, vaginal, or neovaginal) with a partner known to be HIV-infected or of unknown HIV infection status according to self report
Inclusion Criteria for Women Who Have Sex With Men (WSM):
- Female at birth or self identify as female
- Not pregnant or breastfeeding
- Not able to or not intending to become pregnant during the next year
- If able to become pregnant, self reported use of an effective method of contraception at Enrollment, and intending to use an effective method for the next 34 weeks
- One or more of the following risk factors for HIV acquisition in the past 6 months according to self report: sexual intercourse with more than one man; history of an acute STI; sex in exchange for money, goods or favors; condomless intercourse (oral, anal, or vaginal) with a partner known to be HIV-infected or of unknown HIV infection status
Exclusion Criteria
- Proteinuria 2+ or greater at screening
- Glucosuria 2+ or greater at screening
- Serious and active medical or mental illness
- One or both HIV rapid tests is reactive at screening or enrollment, regardless of subsequent HIV diagnostic test results
- Signs or symptoms suggestive of acute HIV infection
- Use of hypoglycemic agents for diabetes or agents with known nephrotoxic potential
- Use of ARV therapy (e.g., for post-exposure prophylaxis [PEP] or PrEP) in the 90 days prior to study entry
- Serum phosphate level below site laboratory LLN
- Current participation (or participation within 3 months of screening) in any HIV prevention study
- Previous or current participation in the active arm of an HIV vaccine trial
- Acute or chronic hepatitis B (HBV) infection (refers to chronic active HBV infection evidenced by a positive test for hepatitis B surface antigen (HBsAg)
- Presence of a psychological or social condition or an addictive disorder that would preclude compliance with the protocol
- Any other reason or condition that in the opinion of the investigator would interfere with participation, complicate interpretation of study outcome data, or otherwise interfere with achieving the study objectives
Data sourced from ClinicalTrials.gov (NCT01327651). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.