NOTRE: Optimizing Long-Acting Pre-Exposure Prophylaxis and Medications for Opioid Use Disorder Interventions in Carceral Settings

Trial statusNot yet recruiting
Trial phasePhase 4
Trial typeInterventional
Biological sexAll
Age18+
SponsorDuke University

About this trial

The investigators plan to conduct an R61/33 hybrid type 2 implementation-effectiveness trial that includes 1) a one-year exploratory R61 phase that will enable the development of the intervention protocol needed for the R33 trial phase including concrete R61 phase milestones; 2) a four-year R33 phase that will include a concurrent implementation evaluation and a randomized control trial.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

Adults (age 18) at a participating carceral site;

Eligible for release within 120 days (sentenced and/or pretrial). Individuals who might be sentenced to federal prison will be excluded;

History of OUD (meeting DSM-5 criteria of moderate or severe opioid use disorder at the time of incarceration; individuals not meeting the opioid-disorder criterion will be eligible if they were treated in an opioid agonist treatment program during the year before incarceration or met OUD criteria in the year prior to incarceration);

HIV negative (as confirmed by a HIV rapid test);

Disqualifiers

Liver function test levels greater than four times normal (if we are unable to obtain labs, a determination by our site partner physicians will be made to allow inclusion);

Active medical illness that may make participation hazardous (e.g., unstable diabetes, heart disease; renal impairment, Hepatitis B);

Conditions or medications that may predispose to QTc prolongation (personal or family history of long QT syndrome, hypokalemia, medications that prolong QTc interval, e.g., macrolide antibiotics, azole antifungal compounds, anti-arrhythmics, antipsychotics and antidepressants);

Untreated psychiatric disorder that may make participation hazardous (e.g., untreated psychosis, treated psychiatric disorders will be allowed);

Trial design

Design model

Parallel

Treatments tested in this trial

  • Cabotegravir Injection

    Drug

    Long-acting injection (LAI) Prep + X-RB treatment initiated in jail or prison.

  • Cabotegravir Pill

    Drug

    Oral PrEP + SL-B treatment initiated in jail or prison.

  • Buprenorphine injection

    Drug

    Long-acting injection (LAI) Prep + X-RB treatment initiated in jail or prison.

  • Buprenorphine Pill

    Drug

    Oral PrEP + SL-B treatment initiated in jail or prison.

Treatment groups

450 Participants
are divided into 2 treatment groups
Group A: Daily Oral Pill ArmActive comparator 2 interventions
Group B: Long Acting Injectable ArmExperimental treatment 2 interventions

Trial outcomes

Primary outcomes

1

PrEP adherence, time to dropout

Dropout is defined as missing treatment for 7 consecutive days.

Time frame
up to 12 months
2

Buprenorphine adherence, time to dropout

Dropout is defined as missing treatment for 7 consecutive days.

Time frame
up to 12 months

Secondary outcomes

1

Substance use as measured by number of participants with positive Urine Drug Test (UDT)

Time frame
up to 12 months
2

Number of participants with a fatal or non-fatal overdose

Time frame
up to 12 months
3

Number of participants engaging in HIV risk behaviors

Time frame
up to 12 months
4

Number of participants with past criminal system engagement

Time frame
Baseline

Other outcomes

Sponsors and contacts

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Duke University

Lead sponsor

Friends Research Institute, Inc.

Collaborator

The Miriam Hospital

Collaborator

University of Arkansas

Collaborator

National Institute on Drug Abuse (NIDA)

Collaborator

This trial is not recruiting at the moment. You can still explore other options: