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.
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.
Study Type
OBSERVATIONAL
Enrollment
58
Children's Hospital of Los Angeles
Los Angeles, California, United States
University of Miami
Miami, Florida, United States
University of Southern Florida College of Medicine
Tampa, Florida, United States
Retrospective self-assessment of consent competence as assessed by completion of web-based survey
Time frame: Day 1
Retrospective self-assessment of consent competence as assessed by completion of in-depth interview with selected participants
Time frame: 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
Time frame: Day 1
Retrospective self-assessment of consent disclosure as assessed by completion of in-depth interview with selected participants
Time frame: 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
Time frame: Day 1
Retrospective self-assessment of consent understanding as assessed by completion of in-depth interview with selected participants
Time frame: 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
Time frame: Day 1
Retrospective self-assessment of consent voluntariness as assessed by completion of in-depth interview with selected participants
Time frame: 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
Time frame: Day 1
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Stroger Hospital of Cook County
Chicago, Illinois, United States
Tulane Medical Center
New Orleans, Louisiana, United States
Johns Hopkins University
Baltimore, Maryland, United States
Fenway Institute
Boston, Massachusetts, United States
Wayne State University
Detroit, Michigan, United States
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
St. Jude Childrens Research Hospital
Memphis, Tennessee, United States
...and 1 more locations
Use of social support and information seeking in the consent process as assessed by completion of in-depth interview with selected participants
Time frame: 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
Time frame: Day 1
Experienced harms and benefits associated with autonomous research decision-making as assessed by completion of in-depth interview with selected participants
Time frame: 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
Time frame: 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
Time frame: One-time interview completed no more than 60 days after consent
Post-ATN 110 or ATN 113 study PrEP use and experiences as assessed by completion of web-based survey
Time frame: Day 1
Post-ATN 110 or ATN 113 study PrEP use and experiences as assessed by completion of in-depth interview with selected participants
Time frame: 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
Time frame: Day 1
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
Time frame: 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
Time frame: Day 1
Need for additional support in the decision making process for clinical trial participation as assessed by in-depth interview with selected participants
Time frame: One-time interview completed no more than 60 days after consent
Self-assessment of adherence as assessed by web-based survey
Time frame: Day 1
Self-assessment of adherence as assessed by in-depth interview with selected participants
Time frame: One-time interview completed no more than 60 days after consent
Benefit or harm from participation as assessed by completion of web-based survey
Time frame: Day 1
Benefit or harm from participation as assessed by completion of in-depth interview with selected participants
Time frame: One-time interview completed no more than 60 days after consent