RCT of an Integrative Intervention for Non-Treatment-Seeking Meth Users

In the era of HIV treatment as prevention (TasP), efforts are needed to identify
evidence-based combination prevention approaches that achieve greater decreases HIV viral
load among populations that are more likely to engage in HIV transmission risk behavior.
Because methamphetamine-using men who have sex with men (MSM) are at greater risk for
acquiring and transmitting HIV, interventions targeting stimulant use in this population of
high-risk men could boost the effectiveness of TasP. At present, only conditional cash
transfer approaches such as contingency management (CM) have demonstrated short- term
efficacy in reducing stimulant use among substance-using MSM who are not actively seeking
formal treatment. The proposed RCT will examine the efficacy of a positive affect
intervention that is designed to optimize the effectiveness of CM to achieve long-term
reductions in stimulant use and HIV viral load in this population. the team will examine the
efficacy of this integrative intervention in a randomized controlled trial (RCT) with 110
HIV-positive, methamphetamine-using MSM. After enrolling in CM, participants will be
randomized to receive either: 1) the positive affect intervention; or 2) a attention-matched
control condition. Follow-up data will be collected at 3, 6, 12, and 15 months
post-randomization. This RCT will provide an opportunity to examine the efficacy of an
integrative intervention designed to promote long-term reductions in HIV viral load as the
primary outcome. Secondary outcomes that will be examined include: increases positive affect,
reductions in stimulant use, improvements in T-helper (CD4+) count, unsuppressed viral load,
and decreases HIV transmission risk behavior. Identifying an efficacious intervention
approach to decrease HIV viral load among methamphetamine-using MSM would substantially
support the goals of the National HIV/AIDS Strategy to reduce HIV incidence and mitigate
HIV-related health disparities.