HIV, PrEP
Conditions
Keywords
HIV, Self-Consent, PrEP, Autonomous Research Consent, Participation-associated Outcomes
Brief summary
This study involves a one-time, web-based quantitative structured self-complete (web-based) survey for all subjects and a qualitative semi-structured (qualitative) interview for a selected sub-sample of subjects to evaluate the consent processes in association with research outcomes, specifically early adherence to Pre-exposure Prophylaxis (PrEP) and Human Immunodeficiency Virus (HIV) seroconversion at any point during participation in the ATN 110 or ATN 113 study.
Detailed description
Decisional autonomy is a foundational, nearly inviolable principle of contemporary human subjects research. Autonomy refers to a deliberative outcome reflecting an individual's choice, outside of controlling influences of other agents. From the perspective of research participation decision-making, autonomy incorporates five elements of consent: competence; disclosure; understanding; voluntariness; and, consent. Adequate research consent processes are thought to be challenged by group-level qualities that define a vulnerable population in need of protection from coercion or undue influence. Age (typically less than age 18 in the United States) is a widely accepted status-defining vulnerability. Sexual minority identity or same-sex behavior does not define a vulnerable population but 45 Code of Federal Regulations (CFR) 46 subpart A (Common Rule) allows appropriate protections for other vulnerable populations as determined by an individual Institutional Review Board (IRB). The specific aims of this study address issues within a larger domain of questions about the primacy of decisional autonomy, and associations of autonomous research consent and subsequent participation-associated outcomes. This mixed-methods study will enroll young men who have sex with men (YMSM) and transgender women who have sex with men who are currently or were previously enrolled in the ATN 110 or ATN 113 study. Data from the web-based survey will be used to test hypotheses about the relationships between participant age, elements of the consent process, and two key participation outcomes (early adherence to PrEP, HIV seroconversion) in the ATN 110 or ATN 113 study. Data from the qualitative interview will be used to explore in further depth age-related vulnerability and disclosure vulnerabilities manifested for participants and whether/how they influenced ATN 110 and ATN 113 study outcomes. The interview will also assess decisional support and the benefits or harms associated with participation.
Interventions
None listed
Sponsors
National Institute on Drug Abuse (NIDA)
National Institute of Mental Health (NIMH)
University of North Carolina, Chapel Hill
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
MALE
Age
15 Years to 22 Years
Healthy volunteers
Yes
Inclusion criteria
To be considered eligible for enrollment into ATN 137, an individual must meet all of the criteria listed below. * Is currently or was previously enrolled in the ATN 110 or ATN 113 study; and * Is willing and able to provide informed consent via online informed consent form (ICF).
Exclusion criteria
To be considered eligible for enrollment, an individual must not meet any of the criteria listed below. * Prematurely discontinued from the ATN 110 or ATN 113 study due to withdrawal of consent or inadvertent enrollment. * Inability to complete the web-based quantitative structured self-completed survey in its entirety in a single sitting immediately after consent is provided.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Post-ATN 110 or ATN 113 study PrEP use and experiences as assessed by completion of web-based survey | Day 1 |
| Post-ATN 110 or ATN 113 study PrEP use and experiences as assessed by completion of in-depth interview with selected participants | One-time interview completed no more than 60 days after consent |
| Retrospective self-assessment of consent voluntariness as assessed by completion of in-depth interview with selected participants | One-time interview completed no more than 60 days after consent |
| Use of social support and information seeking in the consent process as assessed by completion of web-based survey | Day 1 |
| Use of social support and information seeking in the consent process as assessed by completion of in-depth interview with selected participants | One-time interview completed no more than 60 days after consent |
| Experienced harms and benefits associated with autonomous research decision-making as assessed by completion of web-based survey | Day 1 |
| Experienced harms and benefits associated with autonomous research decision-making as assessed by completion of in-depth interview with selected participants | One-time interview completed no more than 60 days after consent |
| Experiences with HIV testing and PrEP adherence technologies including home-based HIV testing Wisepill devices and text message adherence reminders as assessed by completion of web-based survey | Day 1 |
| Experiences with HIV testing and PrEP adherence technologies including home-based HIV testing Wisepill devices and text message adherence reminders as assessed by completion of in-depth interview with selected participants | One-time interview completed no more than 60 days after consent |
| Retrospective self-assessment of consent competence as assessed by completion of web-based survey | Day 1 |
| Retrospective self-assessment of consent competence as assessed by completion of in-depth interview with selected participants | One-time interview completed no more than 60 days after consent |
| Retrospective self-assessment of consent disclosure as assessed by completion of web-based survey | Day 1 |
| Retrospective self-assessment of consent disclosure as assessed by completion of in-depth interview with selected participants | One-time interview completed no more than 60 days after consent |
| Retrospective self-assessment of consent understanding as assessed by completion of web-based survey | Day 1 |
| Retrospective self-assessment of consent understanding as assessed by completion of in-depth interview with selected participants | One-time interview completed no more than 60 days after consent |
| Retrospective self-assessment of consent voluntariness as assessed by completion of web-based survey | Day 1 |
Secondary
| Measure | Time frame |
|---|---|
| Types of vulnerabilities (i.e., age, sexual identity, sexual behavior, and race-related) that influenced ATN 110 and ATN 113 study outcomes as assessed by completion of in-depth interview with selected participants | One-time interview completed no more than 60 days after consent |
| Need for additional support in the decision making process for clinical trial participation as assessed by web-based survey | Day 1 |
| Need for additional support in the decision making process for clinical trial participation as assessed by in-depth interview with selected participants | One-time interview completed no more than 60 days after consent |
| Self-assessment of adherence as assessed by web-based survey | Day 1 |
| Self-assessment of adherence as assessed by in-depth interview with selected participants | One-time interview completed no more than 60 days after consent |
| Benefit or harm from participation as assessed by completion of web-based survey | Day 1 |
| Benefit or harm from participation as assessed by completion of in-depth interview with selected participants | One-time interview completed no more than 60 days after consent |
| Types of vulnerabilities (i.e., age, sexual identity, sexual behavior, and race-related) that influenced ATN 110 and ATN 113 study outcomes as assessed by completion of web-based survey | Day 1 |
Countries
United States
Outcome results
None listed