Pilot Randomized Controlled Trial of a Syndemics Intervention with HIV-Positive, Cocaine-Using Women

Danita Jemison, Sequoia Jackson, Olorunleke Oni, Deva Cats-Baril, Shawdae Thomas-Smith, Abigail Batchelder, Allan Rodriguez, Samantha E. Dilworth, Lisa R. Metsch, Deborah Jones, Daniel J. Feaster, Conall O’Cleirigh, Gail Ironson, Adam W. Carrico

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


This pilot randomized controlled trial examined the feasibility and acceptability of a Syndemics intervention targeting the intersection of stimulant use, trauma, and difficulties with HIV disease management in cocaine-using women. All participants received contingency management (CM) for 3 months with financial incentives for stimulant abstinence during thrice-weekly urine screening and refilling antiretroviral medications monthly. Sixteen participants were randomized to complete four expressive writing (n = 9) or four neutral writing (n = 7) sessions delivered during the CM intervention period. Completion rates for writing sessions were high (15 of 16 women completed all four sessions) and engagement in CM urine screening was moderate with women randomized to expressive writing providing a median of 11 non-reactive urine samples for stimulants. There were non-significant trends for those randomized to expressive writing to provide more CM urine samples that were non-reactive for stimulants, report greater decreases in severity of cocaine use, and display reductions in log10 HIV viral load at 6 months. Although the Syndemics intervention was feasible and acceptable to many women, qualitative interviews with eligible participants who were not randomized identified structural and psychological barriers to engagement. Further clinical research is needed to test the efficacy of Syndemics interventions with HIV-positive, cocaine-using women.

Original languageEnglish (US)
Pages (from-to)2467-2476
Number of pages10
JournalAIDS and Behavior
Issue number9
StatePublished - Sep 1 2019


  • Cocaine
  • Contingency management
  • Expressive writing
  • Syndemics
  • Viral load

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


Dive into the research topics of 'Pilot Randomized Controlled Trial of a Syndemics Intervention with HIV-Positive, Cocaine-Using Women'. Together they form a unique fingerprint.

Cite this