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Randomized Controlled Trial
. 2023 Jun;27(6):1962-1971.
doi: 10.1007/s10461-022-03929-6. Epub 2022 Nov 21.

Contingency Management for Integrated Harm Reduction Among Men Who Have Sex with Men Who Use Methamphetamine in Los Angeles: A Pilot Assessment

Cheríe S Blair  1 , Monica Gandhi  2 , Steven Shoptaw  3   4 , Christopher Blades  3 , Jesse L Clark  5   3
Affiliations
Randomized Controlled Trial

Contingency Management for Integrated Harm Reduction Among Men Who Have Sex with Men Who Use Methamphetamine in Los Angeles: A Pilot Assessment

Cheríe S Blair et al. AIDS Behav. 2023 Jun.

Abstract

Methamphetamine (MA) use is associated with HIV transmission among men who have sex with men (MSM) and lapses in medication adherence. Contingency Management (CM) is effective in reducing MA use, but studies of CM to support adherence to HIV prevention or treatment are limited. We conducted a pilot trial of a CM intervention to reduce MA use and improve PrEP/ART adherence among MSM prescribed a tenofovir (TFV)-based regimen for HIV prevention or treatment. Participants were randomly assigned to receive escalating incentives for either MA abstinence or TFV adherence (based on point-of-care urine testing), and to a monitoring schedule of either 2 or 3 visits/week for 4 weeks. 19 MSM were randomized to either CM for MA use or CM for PrEP/ART adherence (median age: 38; IQR: 28-46) and 15 were living with HIV. Participants attended 95.7% (67/70) of scheduled visits in the 2x/week arm and 74.8% (74/99) in the 3x/week arm. TFV adherence was higher among participants in the TFV adherence arm with 93.5% (n = 72/77) of urine samples positive for TFV, compared to 76.6% (n = 49/64) in the MA abstinence arm (p = 0.007). Participants in the MA abstinence arm had more urine samples negative for MA metabolites (20.3%, n = 13/64) than those receiving CM for TFV adherence (6.5%, n = 5/77; p = 0.021). A CM model for MA abstinence and PrEP/ART adherence using twice-weekly visits and urine testing for MA and TFV for MSM who use MA is feasible and potentially effective as an integrated harm reduction strategy.

Keywords: adherence; contingency management; men who have sex with men; stimulant use; substance use.

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Conflict of interest statement

Conflict of interest /Competing interests.

The authors declare that they have no conflict of interest.

Figures

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Fig. 1
Screening and randomization of participants
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References

    1. Centers for Disease Control and Prevention. HIV infection risk, prevention, and testing behaviors among men who have sex with men - National HIV Behavioral Surveillance, 23 U.S. cities, 2017 2019.
    1. Centers for Disease Control and Prevention. Surveillance Report HIV. 2019. 2021;32.
    1. Reback CJ, Fletcher JB. Elevated HIV and STI prevalence and incidence among methamphetamine-using men who have sex with men in Los Angeles County. AIDS Educ Prev. 2018;30(4):350–6. - PMC - PubMed
    1. Nerlander LMC, Hoots BE, Bradley H, Broz D, Thorson A, Paz-Bailey G. HIV infection among MSM who inject methamphetamine in 8 US cities. Drug Alcohol Depend. 2018;190:216–23. - PMC - PubMed
    1. Halkitis PN, Levy MD, Moreira AD, Ferrusi CN. Crystal methamphetamine use and HIV transmission among gay and bisexual men. Curr Addict Rep. 2014;1(3):206–13.

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