A pilot trial of integrated behavioral activation and sexual risk reduction counseling for HIV-uninfected men who have sex with men abusing crystal methamphetamine

Matthew J. Mimiaga, Sari L. Reisner, David W. Pantalone, Conall O'Cleirigh, Kenneth H. Mayer, Steven Safren

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Crystal methamphetamine use is a major driver behind high-risk sexual behavior among men who have sex with men (MSM). Prior work suggests a cycle of continued crystal methamphetamine use and high-risk sex due to loss of the ability to enjoy other activities, which appears to be a side effect of this drug. Behavioral activation (BA) is a treatment for depression that involves learning to reengage in life's activities. We evaluated a novel intervention for crystal methamphetamine abuse and high-risk sex in MSM, incorporating 10 sessions of BA with integrated HIV risk reduction counseling (RR). Forty-four subjects were screened, of whom 21 met initial entry criteria. A total of 19 participants enrolled; 16 completed an open-phase study of the intervention. Behavioral assessments were conducted at baseline, 3 months postbaseline, and 6 months postbaseline. Linear mixed effects regression models were fit to assess change over time. Mean unprotected anal intercourse (UAI) episodes decreased significantly from baseline to acute postintervention (β=-4.86; 95% confidence interval [CI]=-7.48, -2.24; p=0.0015) and from baseline to 6 months postbaseline (β=-5.07; 95% CI=-7.85, -2.29; p=0.0017; test of fixed effects χ2=16.59; df=2,13; p=0.0002). On average, there was a significant decrease over time in the number of crystal methamphetamine episodes in the past 3 months (χ2=22.43; df=2,15; p2=9.21; df=2,15; p=0.010). Statistically significant reductions in depressive symptoms and poly-substance use were also maintained. Adding behavioral activation to risk reduction counseling for MSM with problematic crystal methamphetamine use may augment the potency of a risk reduction intervention for this population. Due to the small sample size and time intensive intervention, future testing in a randomized design is necessary to determine efficacy, with subsequent effectiveness testing.

Original languageEnglish (US)
Pages (from-to)681-693
Number of pages13
JournalAIDS Patient Care and STDs
Volume26
Issue number11
DOIs
StatePublished - Nov 1 2012
Externally publishedYes

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Methamphetamine
Risk Reduction Behavior
Counseling
HIV
Unsafe Sex
Confidence Intervals
Depression
Aptitude
Risk-Taking
Drug-Related Side Effects and Adverse Reactions
Sexual Behavior
Sample Size
Learning
Population

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

A pilot trial of integrated behavioral activation and sexual risk reduction counseling for HIV-uninfected men who have sex with men abusing crystal methamphetamine. / Mimiaga, Matthew J.; Reisner, Sari L.; Pantalone, David W.; O'Cleirigh, Conall; Mayer, Kenneth H.; Safren, Steven.

In: AIDS Patient Care and STDs, Vol. 26, No. 11, 01.11.2012, p. 681-693.

Research output: Contribution to journalArticle

Mimiaga, Matthew J. ; Reisner, Sari L. ; Pantalone, David W. ; O'Cleirigh, Conall ; Mayer, Kenneth H. ; Safren, Steven. / A pilot trial of integrated behavioral activation and sexual risk reduction counseling for HIV-uninfected men who have sex with men abusing crystal methamphetamine. In: AIDS Patient Care and STDs. 2012 ; Vol. 26, No. 11. pp. 681-693.
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