TY - JOUR
T1 - Behavioral treatment approaches for methamphetamine dependence and HIV-related sexual risk behaviors among urban gay and bisexual men
AU - Shoptaw, Steven
AU - Reback, Cathy J.
AU - Peck, James A.
AU - Yang, Xiaowei
AU - Rotheram-Fuller, Erin
AU - Larkins, Sherry
AU - Veniegas, Rosemary C.
AU - Freese, Thomas E.
AU - Hucks-Ortiz, Christopher
PY - 2005/5/9
Y1 - 2005/5/9
N2 - 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.
AB - 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.
KW - Cognitive behavioral therapy
KW - Contingency management
KW - Gay and bisexual men
KW - HIV
KW - Methamphetamine
KW - Sexual risk behaviors
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UR - http://www.scopus.com/inward/citedby.url?scp=17444409690&partnerID=8YFLogxK
U2 - 10.1016/j.drugalcdep.2004.10.004
DO - 10.1016/j.drugalcdep.2004.10.004
M3 - Article
C2 - 15845315
AN - SCOPUS:17444409690
SN - 0376-8716
VL - 78
SP - 125
EP - 134
JO - Drug and alcohol dependence
JF - Drug and alcohol dependence
IS - 2
ER -