Abstract | BACKGROUND:
Methamphetamine-dependent gay and bisexual men (GBM) are at high risk for HIV transmission, largely due to drug-associated sexual risk behaviors. This project evaluated the efficacy of four behavioral drug abuse treatments for reducing methamphetamine use and sexual risk behaviors among this population. METHODS: In this randomized controlled trial, 162 methamphetamine-dependent (SCID-verified) GBM in Los Angeles County were randomly assigned to one of four treatment conditions for 16 weeks: standard cognitive behavioral therapy (CBT, n=40), contingency management (CM, n=42), combined cognitive behavioral therapy and contingency management (CBT+CM, n=40), and a culturally tailored cognitive behavioral therapy (GCBT, n=40). Stimulant use was assessed thrice-weekly during treatment using urine drug screens (48 measures). Sexual risk behaviors were monitored monthly (four measures). Follow-up assessments were conducted at 6 (80.0%) and 12 months (79.9%). RESULTS: Statistically significant differences in retention (F(3,158)=3.78, p<.02), in longest period of consecutive urine samples negative for methamphetamine metabolites (F(3,158)=11.80, p<.001), and in the Treatment Effectiveness Score were observed by condition during treatment (F(3,158)=7.35, p<.001) with post hoc analyses showing the CM and CBT+CM conditions to perform better than standard CBT. GEE modeling results showed GCBT significantly reduced unprotected receptive anal intercourse (URAI) during the first 4 weeks of treatment (X2=6.75, p<.01). During treatment between-group differences disappeared at follow-up with overall reductions in outcomes sustained to 1-year. CONCLUSIONS: Among high-risk methamphetamine-dependent GBM, drug abuse treatments produced significant reductions in methamphetamine use and sexual risk behaviors. Drug abuse treatments merit consideration as a primary HIV prevention strategy for this population.
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Authors | Steven Shoptaw, Cathy J Reback, James A Peck, Xiaowei Yang, Erin Rotheram-Fuller, Sherry Larkins, Rosemary C Veniegas, Thomas E Freese, Christopher Hucks-Ortiz |
Journal | Drug and alcohol dependence
(Drug Alcohol Depend)
Vol. 78
Issue 2
Pg. 125-34
(May 09 2005)
ISSN: 0376-8716 [Print] Ireland |
PMID | 15845315
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
- Central Nervous System Stimulants
- Methamphetamine
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Topics |
- Acquired Immunodeficiency Syndrome
(prevention & control, psychology, transmission)
- Adolescent
- Adult
- Aged
- Amphetamine-Related Disorders
(therapy, urine)
- Bisexuality
- Central Nervous System Stimulants
- Cognitive Behavioral Therapy
(methods)
- Combined Modality Therapy
- Homosexuality, Male
- Humans
- Los Angeles
- Male
- Methamphetamine
(urine)
- Risk-Taking
- Sexual Behavior
(psychology)
- Substance Abuse Treatment Centers
- Urban Population
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