AEGiS-14IAC: Differential outcomes in a randomized trial of behavioral drug therapies for reducing drug use and HIV-related sexual risk behaviors among gay and bisexual male methamphetamine abusers in Los Angeles.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Differential outcomes in a randomized trial of behavioral drug therapies for reducing drug use and HIV-related sexual risk behaviors among gay and bisexual male methamphetamine abusers in Los Angeles.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. TuOrD1199)

Shoptaw S, Reback CJ, Larkins S, Peck J, Sanders III E
Friends Research Institute/UCLA, Los Angeles, CA, United States

BACKGROUND: Gay/bisexual men in Los Angeles who abuse methamphetamine represent a group at extreme risk for HIV infection due to associations between sexual risk behaviors and drug use. Our NIDA-funded trial evaluated the relative efficacy of relapse prevention (RP; n=41), contingency management (CM; n=42), their combination (RP+CM; n=39), and a culturally specific, RP plus HIV-risk reduction intervention (RPHRR; n=40) in reducing methamphetamine use and sexual risk behaviors. We predicted the RP+CM condition would optimally reduce drug use, while the RPHRR condition would differentially reduce sexual risk behaviors.

METHODS: The design featured a 2-week baseline, followed by randomization to condition, 16 weeks of treatment, and evaluations at 26- and 52-weeks after randomization. Primary dependent variables were drug use (urine samples collected thrice weekly), self-report of unprotected receptive anal intercourse over 30 days (collected every 4 weeks), and retention. The majority (62%) of the sample was infected with HIV.

RESULTS: Longitudinal analysis by condition showed differential effects of the treatments in reducing methamphetamine use (F(1,4452)=4.86; P=.0022), with the RP+CM condition optimally reducing drug use; least reduction for the standard RP condition (T(4452) =-2.17; P=.0304). Significant decreases in reported unprotected receptive anal intercourse were observed for the RPHRR condition (F(3,382)=5.76; P<.001), which produced the steepest rate of decrease in the behavior from baseline to week 4 and maintained the risk reduction during treatment, contrasting with other conditions.

CONCLUSIONS: Findings demonstrate potent effects of behavioral drug therapies for reducing methamphetamine use in this extremely high-risk group. Integration of culturally specific, HIV risk reduction interventions with effective treatment yields differential reduction of reported unprotected anal intercourse beyond that expected from effective treatment alone.

Keywords: AEGIS, Bisexuality, Homosexuality, Male, Homosexuality, Sex Behavior, Methamphetamine, HIV Infections, Risk-Taking, Substance-Related Disorders, HIV Seropositivity, Los Angeles, Safe Sex, Male, Human

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