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

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 <. in="" longest="" period="" of="" consecutive="" urine="" samples="" negative="" for="" methamphetamine="" metabolites="" p="" and="" the="" treatment="" effectiveness="" score="" were="" observed="" by="" condition="" during="" with="" post="" hoc="" analyses="" showing="" cm="" cbt="" conditions="" to="" perform="" better="" than="" standard="" cbt.="" gee="" modeling="" results="" showed="" gcbt="" significantly="" reduced="" unprotected="" receptive="" anal="" intercourse="" first="" weeks="" between-group="" differences="" disappeared="" at="" follow-up="" overall="" reductions="" outcomes="" sustained="" conclusions:="" among="" high-risk="" methamphetamine-dependent="" gbm="" drug="" abuse="" treatments="" produced="" significant="" use="" sexual="" risk="" behaviors.="" merit="" consideration="" as="" a="" primary="" hiv="" prevention="" strategy="" this="" population.="" elsevier="" ireland="" ltd.="" all="" rights="" reserved.="">