Behavioral treatment approaches for methamphetamine dependence and HIV-related sexual risk behaviors among urban gay and bisexual men

Steven Shoptaw, Cathy J. Reback, James A. Peck, Xiaowei Yang, Erin Rotheram-Fuller, Sherry Larkins, Rosemary C. Veniegas, Thomas E. Freese, Christopher Hucks-Ortiz

Research output: Contribution to journalArticlepeer-review

262 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)125-134
Number of pages10
JournalDrug and alcohol dependence
Issue number2
StatePublished - May 9 2005
Externally publishedYes


  • Cognitive behavioral therapy
  • Contingency management
  • Gay and bisexual men
  • HIV
  • Methamphetamine
  • Sexual risk behaviors

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)


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