Title
PRe-Exposure Prophylaxis Acceptability & Readiness Assessments for Toronto gaY, Bisexual and Other Men Who Have Sex With Men-5
A Pilot Study of Daily TDF/FTC-based PrEP Among High-risk Toronto MSM:The PREPARATORY-5 Study
Phase
Phase 4Lead Sponsor
University of TorontoStudy Type
InterventionalStatus
Completed No Results PostedIndication/Condition
HIV Human Immunodeficiency VirusIntervention/Treatment
tenofovir emtricitabine ...Study Participants
52Canada continues to see an unrelenting stream of new HIV diagnoses, with a disproportionate burden among gay, bisexual, and other MSM in major centers such as Toronto. Pre-exposure prophylaxis (PrEP) with oral, daily tenofovir/emtricitabine (TDF/FTC, Truvada®) is a novel biomedical approach to HIV prevention shown in the iPrEx trial to be safe and efficacious in reducing HIV acquisition by 44% among MSM, when provided in a comprehensive package of HIV prevention interventions including counseling, testing/treatment of sexually transmitted infections (STIs), and condoms. There is now widespread mobilization to assess the feasibility of PrEP roll-out worldwide, with urgent calls for 'demonstration projects' addressing real-world PrEP implementation issues.
PREPARATORY-5 is Canada's first PrEP demonstration project, and will examine real-world PrEP implementation issues including acceptability, effectiveness, impact on sexually transmitted infections, and strategies for supporting adherence outside the clinical trial setting. The investigators have also established a comprehensive community-based research program investigating the role of community-based organizations in PrEP implementation and delivery.
Once daily Tenofovir/emtricitabine (Truvada®)
MSM receiving once daily TDF/FTC-based (Truvada®) pre-exposure prophylaxis
Inclusion Criteria: Self-identified man who has sex with men Age 18 years or older Able to communicate in both written and oral english HIRI-MSM score greater than or equal to 10 At least one self-reported unprotected receptive anal sex act over the preceding 6 months Creatinine clearance greater than or equal to 60mL/min by Modified Diet in Renal Disease (MDRD) formula HIV un-infected at screening using standard ELISA and Western Blot testing Exclusion Criteria: Clinical signs or symptoms suggestive of an HIV seroconversion illness within the last 3 months in the opinion of the investigator Use of pre- or post-exposure prophylaxis within the last 3 months Use of concomitant nephrotoxic drugs Use of concomitant immune modulatory drugs Hepatitis B surface antigen positivity Any condition or concomitant medication portending an increased risk of osteoporosis Enrollment in any other HIV prevention program or trial