Social Network Intervention for HIV Prevention

Recruiting at 1 trial location

Overseen By Gregory Lucas, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Johns Hopkins University

Disqualifiers: Lacking capacity to consent

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

360 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to evaluate how effectively a social network approach assists people who inject drugs in Maryland in getting tested for HIV and accessing prevention and treatment services. Participants will join either a peer-educator group, where they learn to communicate about HIV prevention and distribute self-test kits and naloxone, or a control group focused on understanding the opioid overdose epidemic. The study will measure how these different approaches impact HIV testing rates, knowledge, and use of HIV prevention and treatment services. People who have recently used syringe service programs and inject drugs could be ideal candidates for this trial. As an unphased trial, this study offers a unique opportunity to contribute to innovative strategies for HIV prevention and support.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators for more details.

What prior data suggests that this social network intervention is safe for participants?

Studies have shown that teaching people about HIV through their peers effectively and safely prevents the virus's spread. Research indicates that this method can lead to lasting behavioral changes among high-risk groups. For example, one study found that after two years of peer education, participants were much more likely to get tested for HIV.

Additionally, learning from peers has been linked to a better understanding of HIV and safer habits. It helps people learn how to protect themselves and others. These studies have reported no major safety issues. Overall, peer education is well-received and positively impacts both awareness and behavior related to preventing HIV. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores a fresh approach to preventing HIV through a peer-educator-based network intervention. Unlike traditional methods that focus on medical treatments or individual behavior change, this strategy empowers network members to communicate effectively and promote frequent HIV testing and prevention services within their communities. A standout feature is the training to use and distribute HIV self-test kits and naloxone, allowing for immediate action and support among peers. This community-centered model could lead to more sustainable and widespread HIV prevention, especially in areas heavily impacted by the virus.

What evidence suggests that this trial's treatments could be effective for HIV prevention?

Research has shown that peer-led education about HIV can greatly improve understanding and reduce risky behaviors in high-risk groups. A review of several studies found that these programs more than doubled HIV knowledge. In some cases, they also led to lasting increases in HIV testing rates, with positive effects still visible after two years. This method effectively encourages safer behaviors and boosts the use of HIV prevention services. In this trial, participants in the peer-educator-based network intervention arm will receive training to serve as peer educators, highlighting the potential of peer educator networks as a promising way to strengthen HIV prevention efforts. ^{1 2 3 4 6}

Who Is on the Research Team?

Oluwaseun Falade-Nwulia, MD

Principal Investigator

Johns Hopkins School of Medicine

Are You a Good Fit for This Trial?

This trial is for adults over 18 in Maryland who use syringe service programs and can recruit at least one drug-using peer. They must speak English, be willing to undergo training, and discuss HIV prevention. People unable to consent are excluded.

Inclusion Criteria

I have a valid coupon or remember the 3-digit ID number.

Inclusion criteria for index participants:

I am willing to attend training and weekly group sessions.

Exclusion Criteria

I am unable to make medical decisions for myself.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Participants complete initial study assessments and are randomized into intervention or control arms

1 week

1 visit (in-person)

Intervention

Participants in the peer-educator arm receive training on communication, HIV testing, and prevention services; control arm receives training on opioid overdose

3 months

Ongoing sessions (in-person and virtual)

Follow-up

Participants are monitored for HIV testing, PrEP uptake, and MOUD initiation at 3 and 9 months

9 months

2 visits (in-person) at 3 and 9 months

What Are the Treatments Tested in This Trial?

Interventions

• Peer-educator-based network

Trial Overview The study tests if a peer-educator network can increase HIV testing, PrEP knowledge, uptake of HIV services/PrEP, and medication for opioid use disorder among people who inject drugs compared to an overdose education control group.

How Is the Trial Designed?

Group I: Peer-educator-based network intervention Experimental Treatment 1 Intervention

Indexes randomized to the intervention arm will complete a training program that emphasizes effective communication, frequent HIV testing, and awareness of evidence-based HIV prevention and treatment services. An important innovation to the network intervention will be training indexes to use and distribute HIV self-test kits and naloxone to their network members (NMs).

Group II: Equal-attention control Active Control 1 Intervention

This group will receive training sessions that will be focused on the opioid overdose epidemic and will not include any training to serve as a peer educator.

Who Is Running the Clinical Trial?

Johns Hopkins University

Lead Sponsor

Trials

2,366

Recruited

15,160,000+

National Institute on Drug Abuse (NIDA)

Collaborator

Trials

2,658

Recruited

3,409,000+

Maryland Department of Health and Mental Hygiene

Collaborator

Trials

9

Recruited

5,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3927325/

Effectiveness of Peer Education Interventions for HIV ... In meta-analysis, peer education interventions were significantly associated with increased HIV knowledge (OR:2.28; 95% CI:1.88, 2.75), reduced equipment ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7218508/

Peer education for HIV prevention among high-risk groups Our study shows that peer education is an effective tool with long-term impact for behavior change among high-risk HIV groups worldwide.

3. tandfonline.com tandfonline.com/doi/full/10.1080/26410397.2022.2129374

Full article: Peer education interventions for HIV prevention ... Nearly two-thirds (11/17; 65%) of studies indicated the effectiveness of peer educators in reaching other young people, particularly “vulnerable ...

4. bmcinfectdis.biomedcentral.com bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-05003-9

Peer education for HIV prevention among high-risk groups The persistent effect of peer education on HIV testing was significant with an overall OR of 6.85 after 24 months of intervention, higher than ...

5. journals.plos.org journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004150

The PEBRA cluster-randomized trial | PLOS Medicine Preference-based peer-coordinated care for young people living with HIV, compared to nurse-based care only, did not lead to conclusive evidence for an effect ...

6. journals.plos.org journals.plos.org/plosone/article?id=10.1371/journal.pone.0232347

Effects of a peer educator program for HIV status disclosure ... In turn, 92.7% of partners (n = 508) who had received HIV-related exposure information were tested; of these, 78.7% (n = 400) were found to be HIV-positive. Of ...