In pursuit of our mission, the Center conducts research on medical, behavioral, and combination approaches to the prevention and treatment of chronic illnesses, with a particular focus on addiction and HIV. We also host a data safety and monitoring board that provides support and oversight to dozens of researchers. We stress the values of integrity and scientific rigor in the conduct of our research and work closely with the communities we serve to ensure that the best of care is given.
Accelerated Development of Additive Pharmacotherapy Treatment (ADAPT-2) for Methamphetamine Use Disorder
DESCRIPTION: The primary objective of this double-blind, placebo-controlled, adaptive, randomized clinical trial is to evaluate the efficacy of extended-release naltrexone plus bupropion as a combination pharmacotherapy for methamphetamine use disorder. Secondary outcomes will assess the safety of naltrexone plus bupropion and determine the efficacy of the combination pharmacotherapy on other substance use outcomes, on depression symptom scores, and on quality of life ratings. 370 individuals with moderate or severe methamphetamine use disorder will be randomly…
ACTTION Phenotyping Substance Use Disorder
RELEVANCE: Phenotyping is a tool that has been recently introduced in the study of addiction and can be used to improve diagnosis and overall treatment outcomes. It aids in the identification of biological and behavioral markers of severity that can be useful in determining response to treatment. A recent study examined the feasibility and administration of the NIDA Phenotyping Assessment Battery (PhAB), a modular package of assessments and neurocognitive tasks, but the need for a…
CA Bridge Patient Outcomes Research Evaluation Study
RELEVANCE: Medication assisted treatment (MAT) is an essential part of evidence-based rapid response treatment and is highly effective in acute care settings. The California Bridge Program develops hospitals and emergency rooms as primary access points for addiction treatment. This intensive program provides training and technical assistance to acute care providers to encourage patients to enter and remain in treatment. DESCRIPTION: UCLA CBAM is working in collaboration Public Health International (PHI) on a research study related…
CBT4CBT FOR ALCOHOL OR OPIOID USE DISORDER
DESCRIPTION: CBT4CBT (computer-based training for cognitive-behavioral therapy) is a seven-module computerized training in cognitive behavioral therapy. The proposed pilot study will examine the feasibility and acceptability of CBT4CBT in office-based medication treatment of opioid and alcohol use disorders. OUTCOMES: Though this study has completed enrollment, data analysis is still underway. Results will be posted here once available.
Combating Craving with Contingency Management: Neuroplasticity and Methamphetamine Abuse in South Africa
RELEVANCE: Methamphetamine (MA) addiction is a global health problem with high prevalence and great social and health costs in the United States and in the Republic of South Africa and there is a strong need for development and implementation of effective MA treatment approaches. DESCRIPTION: This study will enroll treatment-seeking, MA-dependent individuals into an 8-week contingency management (CM) program. At the beginning and end of the program, participants will participate in MRI scans while performing…
Contingency Management, Methamphetamine Use, and Antiretroviral Adherence for MSM (CMAX)
RELEVANCE: Use of crystal methamphetamine (MA) leads to changes in sexual risk behavior, adherence to biomedical prevention, viral immunology, and mucosal inflammation that increase risk for HIV-1 transmission among MA-using men who have sex with men (MSM), their sexual partners, and their networks. Contingency Management (CM) offers a behavioral modification tool efficacious for reducing frequency of MA use, but the effects of CM on the behavioral and biological factors that promote HIV transmission in MSM…
Determining the Efficacy of Cognitive-Behavioral Motivational Enhancement +/- Nicotine Replacement Therapy for Adolescents
DESCRIPTION: In order to develop a tailored, practical, and efficacious smoking cessation intervention that starts with a behavioral platform and offers the potential for pharmacotherapy (in this instance, nicotine transdermal therapy using Nicoderm CQ®), 84 subjects ages 14-21 were recruited for this 24-week study. Participants reported smoking at least 5 cigarettes daily in the month before entry into the study and initiation of smoking at least 6 months before entry. All youth received 6 weeks…
Expression of stress markers in MSM living with HIV receiving contingency management for methamphetamine use disorder (a.k.a. “EXPRESS+”)
RELEVANCE: Determining whether a patient is both feeling better and improving physiologically when treating people living with HIV (PLWH) for methamphetamine use disorder (MUD) requires identification of a clinically significant measure separate from abstinence. This study aims to address this challenge by testing a gene expression pattern identified by the field of social genomics, which may provide insight into both psychosocial health and biological processes that impact chronic disease risk in PLWH receiving MUD treatment.…
HIV/STD Risk Behaviors in Methamphetamine User Networks — Main Study
DESCRIPTION: Funded by the National Institute on Drug Abuse (U01 DA017394), this project was a part of the SATHCAP (Sexual Acquisition and Transmission of HIV Cooperative Agreement program). The primary purpose of the main study was to determine the extent to which HIV infections spread through drug-related and sexual transmission behaviors. We also sought to identify the individual, network, and structural characteristics that influence the speed, extent and path of transmission. Learn more about the…
HPTN 073: PRE-EXPOSURE PROPHYLAXIS UPTAKE AND ADHERENCE AMONG BLACK MEN WHO HAVE SEX WITH MEN (BMSM)
DESCRIPTION: This is a collaborative project of the national HIV Prevention Trials Network (HPTN), protocol #073 (HPTN 073). The trial will test Truvada®, an HIV treatment medication, for pre-exposure prophylaxis (PrEP). PrEP is a new HIV prevention method in which people who are HIV-negative can be prescribed a daily HIV treatment drug to reduce their risk of becoming infected. The FDA approved Truvada® for use as PrEP in 2012. The Los Angeles site will enroll…
HPTN 083: A Phase 2b/3 Double Blind Safety and Efficacy Study of Injectable Cabotegravir Compared to Daily Oral Tenofovir Disoproxil Fumarate/Emtricitabine (TDF/FTC), for Pre-Exposure Prophylaxis (PrEP) in HIV-Uninfected Cisgender Men and Transgender Women who have Sex with Men
RELEVANCE: PrEP agents are needed that do not depend on daily or near-daily pill-taking. The development of alternative agents for PrEP, and/or more adherence-friendly schedules for currently available agents, could increase prevention choices and increase acceptability. Long-acting injectable agents have the potential to prevent HIV acquisition without relying on adherence to a daily oral regimen. DESCRIPTION: Once randomized to one of two arms, participants will move through the steps below and followed for up to…
HPTN 085: Evaluating the Safety and Efficacy of the VRC01 Antibody in Reducing Acquisition of HIV-1 Infection (AMP)
RELEVANCE: Preliminary data have shown antibodies to be a potential efficacious intervention in preventing HIV-1 infection. DESCRIPTION: This study will evaluate the safety, tolerability, and efficacy of the VRC01 antibody in preventing HIV-1 infection in healthy adults at high risk of HIV infection. Participants will be men who have sex with men (MSM) and transgender people in the U.S., Peru and Brazil. An equal number of study participants will be randomized to receive VRC01 mAb…
HPTN 094: INTEGRA: A Vanguard Study of Health Service Delivery in a Mobile Health Delivery Unit to Link Persons who Inject Drugs to Integrated Care and Prevention for Addiction, HIV, HCV and Primary Care
RELEVANCE: Drug overdose is the leading cause of accidental death in the United States (US), with over 67,000 fatalities in 2018.1 Efforts to address the opioid overdose epidemic are reducing rates of death due to prescription opioids, though the rate of overdose related to fentanyl use continued to rise through 2018.1 The opioid epidemic remains North America’s most widespread behavioral public health problem, with a higher number of deaths due to drug overdose in 2016…
HPTN061: The BROTHERS Study (Broadening the Reach of Testing, Health Education, Resources and Services for Black Men Who Have Sex With Men)
DESCRIPTION: The BROTHERS study, a project of the HIV Prevention Trials Network (HPTN), aimed to see if certain strategies can show promise for slowing down the spread of HIV among Black men who have sex with men (Black MSM). Another aim is to better understand the men’s lives and how that relates to HIV risk. OUTCOMES: The overall rate of new HIV infection among Black MSM in this study was 2.8% per year, a rate that is nearly…
HPV in MA Using and Non-Using MSM in LA — Supplemental Study
DESCRIPTION: This was a sub-study of the project “HIV/STD Risk Behaviors in Methamphetamine User Networks”. It sought measure the prevalence anal human papillomavirus (HPV) among HIV-negative MSM who use methamphetamine compared to those who do not use methamphetamine. OUTCOMES: The supplemental project extends the breadth of research findings in the main study by documenting that the primary drivers of high-risk anal HPV are linked to HIV-infection, MSMW behaviors, and being African American. Use of methamphetamine…
HVTN 302: A phase 1, randomized, open-label clinical trial to evaluate the safety and immunogenicity of HIV trimer mRNA vaccines in healthy, HIV-uninfected adult participants.
RELEVANCE: Development of effective vaccines to protect individuals against HIV is a challenging and growing public health priority. The HVTN’s mission is to fully characterize the safety, immunogenicity, and efficacy of HIV vaccine candidates with the goal of developing a safe, effective vaccine as rapidly as possible for prevention of HIV globally. DESCRIPTION: The HVTN 302 study is a phase 1 clinical trial looking to evaluate the safety and immunogenicity (how the immune system responds)…
Inflammation in Methamphetamine and STIs (aka IMSTI)
RELEVANCE: Methamphetamine (MA) use is common among MSM and is an important driver of the HIV/STI epidemic. Understanding the biological and behavioral risk factors that drive ongoing HIV/STI transmission among MA-using MSM is critical to designing potent HIV prevention interventions. Prevalence of MA use is substantially higher among MSM (5.9% among HIV-negative MSM and 12.3% among MSM living with HIV) than the general population (0.7%) (2,3), with a 707% increase in MA-related mortality in Los…
Methamphetamine-Associated Factors in Recent and Chronic Infection in MSM in Los Angeles — Supplemental Study
DESCRIPTION: This was a sub-study of the project “HIV/STD Risk Behaviors in Methamphetamine User Networks”. The purpose of the project was to assess the characteristics of the HIV virus in methamphetamine-using MSM that may be associated with efficient transmission of new infections. These characteristics include viral load, genotype, extent of treatment. We also sought to evaluate the behavioral similarities between individuals with treatment-resistant strains of HIV such as their patterns of methamphetamine use, sexual practices,…
Methods of Using Real-Time Social Media Technologies for Detection and Remote Monitoring of HIV Outcomes — Supplemental Study
DESCRIPTION: This study sought to establish methods of using real-time social networking data for HIV prevention by assessing 1) whether geolocated conversations about HIV risk behaviors can be extracted from social networking data, 2) the prevalence and content of these conversations, and 3) the feasibility of using HIV risk-related real-time social media conversations as a method to detect HIV outcomes. OUTCOMES: Over 9800 geolocated tweets were extracted and used to create a map displaying the…
Moderna’s mRNA-1273 vaccine, The COVE Study
RELEVANCE: SARS-CoV-2 is the virus that causes the disease called COVID-19, short for “Coronavirus Disease of 2019”. Finding an effective vaccine for COVID-19 is one of several steps being taken to end this global pandemic. DESCRIPTION: The purpose of this study is to test Moderna’s vaccine candidate (mRNA-1273) to see if it can prevent illness if people are exposed to the SARS-CoV-2 virus in their everyday lives. This vaccine is not made from the SARS-CoV-2…
Molecular Epidemiology of HIV in MA Using and Non-Using MSM, MSM/W and Their Partners in LA — Supplemental Study
DESCRIPTION: This was a sub-study of the project “HIV/STD Risk Behaviors in Methamphetamine User Networks”. The purpose this project was to investigate epidemiological clustering of HIV as revealed by viral phylogenetic analysis to support or refute epidemiological linkage of pairs of HIV infected individuals, to describe broad patterns of clustering of infections by ethnic group and by structural features, and to describe the epidemiology of drug resistant HIV within this population OUTCOMES: In our initial…
MSM and Substances Cohort at UCLA Linking Infections Noting Effects, better known as the M Study
RELEVANCE: Stimulant use, especially among men who have sex with men (MSM) in Los Angeles County (LAC) is common. Stimulant drug use, particularly methamphetamine use, is a significant factor in the progression of HIV and STI among MSM in LAC. Non-white MSM are at greatest risk of HIV infection in the United States. Analyses of drug use are needed among diverse samples of MSM in order to understand the impact of drug use on the…
Perceptions of Intentions to Adopt HIV Pre-exposure Prophylaxis Among Black Men Who Have Sex With Men in Los Angeles.
DESCRIPTION: This study assessed perceptions of pre-exposure prophylaxis (PrEP) and their association with PrEP adoption intention among a convenience sample of 224 low socioeconomic status Black men who have sex with men (BMSM) residing in Los Angeles. Participants received educational information about PrEP and completed an in-person interview. OUTCOMES: More than half of the participants indicated a high intention to adopt PrEP. BMSM (18-29 years) were twice as likely to report a high intention to…
Pharmacogenomics and Anti-Addiction Medication Development
DESCRIPTION: Genetic differences are thought to be an important biological predictor of response to treatment for addiction. The purpose of this project was to identify genetic factors influencing addiction severity and response to anti-addiction medications, with an emphasis on medications to treat methamphetamine dependence. We collected DNA specimens from a sample of well-phenotyped methamphetamine users who were participating in our clinical studies, including a pharmacogenetic clinical trial of bupropion for methamphetamine dependence. This outpatient study…
Phase 1 Safety-Interaction Study of Pomaglumetad Methionil For Methamphetamine Use Disorder
RELEVANCE: Despite multiple clinical trials testing medications targeting dopaminergic, serotonergic, cholinergic, and gaba-ergic systems, no effective medication for methamphetamine (MA) use disorder is currently available. DESCRIPTION: This is an inpatient, phase I safety-interaction trial of POMA (Pomaglumetad Methionil) in participants with MA (methamphetamine) use disorder. The goal of the study is to provide the initial safety, tolerability, and pharmacokinetic (PK) data required by the FDA to advance POMA to phase 2 safety and efficacy testing.…
Phase 1B Drug-Drug Interaction Safety Trial of CS-1103 and a Relevant Challenge with IV Methamphetamine
RELEVANCE: There are no FDA approved medications for the treatment of Methamphetamine Use Disorder (MUD). Current treatment options rely heavily on counseling and behavioral interventions. Scientific evidence supports a combination strategy of pharmacotherapy approaches with behavioral therapies to improve patient outcomes and redefine treatment approach for stimulant use disorder. DESCRIPTION: Clear Scientific has developed CS-1103, the first rationally derived small molecule that has capacity for removing methamphetamine from the body. Funded by a grant from…
Phase I Safety Interaction Trial of Ibudilast with Methamphetamine
DESCRIPTION: To date, no medications have been approved expressly for the treatment of methamphetamine dependence, leaving few options for doctors and patients battling this particular addiction. This clinical trial sought to determine the safety and tolerability of the medication ibudilast in non-treatment seeking, methamphetamine-dependent volunteers.The study took place at the Harbor-UCLA Medical Center in Torrance. Preliminary outcomes of the trial were presented at the 2013 College of Problems on Drug Dependence Conference in San Diego.…
Phase I Safety-Interaction Study of Mirtazapine for the Treatment of Methamphetamine Use Disorder
RELEVANCE: Methamphetamine (MA) is more prevalent than many other drugs, including opioids, with 37 million users of MA and amphetamine worldwide and 1.4 million past-year users in the U.S. alone in 2016. The number of MA poisoning deaths has steadily risen in recent years, from >3,700 in 2014 to 10,333 in 2017. Importantly, MA has been recognized as contributing substantially to the U.S. opioid crisis, with about half of MA poisoning deaths also caused by…
Phase II Randomized Trial of Ibudilast For Methamphetamine Dependence
RELEVANCE: Despite numerous clinical trials, no medication has been approved to treat methamphetamine (MA) dependence. As a result, novel approaches to medication development for MA dependence, including linked medication development, where work in early safety trials can be used to inform the importance of continued (or not) assessment of novel or combination pharmacotherapies, is needed. DESCRIPTION: Following up on the Phase I safety trial, the objective of this study is to test the safety and…
Phase II Randomized, Double-Blind Controlled Trial of HORIZANT® for Alcohol Use Disorder
RELEVANCE: Alcohol Use Disorder (AUD) affects 18 million Americans, and is linked to 80,000 deaths a year, presenting a staggering $224 billion dollar economic loss to society. Yet, there are only four medications approved by the FDA to treat AUD. DESCRIPTION: The primary objective of this study is to compare the efficacy of HORIZANT® with a placebo on individuals with AUD. The secondary objectives are to assess other treatment benefits such as reduction in alcohol…
Pilot Randomized Trial of Bupropion for Adolescent Methamphetamine Abuse/Dependence
DESCRIPTION: The purpose of this pilot clinical trial was to determine the safety of bupropion for methamphetamine abuse/dependence among adolescents. Nineteen adolescents were randomly assigned to bupropion sustained release 150mg twice daily or placebo for 8 weeks in addition to outpatient substance abuse counseling. OUTCOMES: Bupropion was well-tolerated except for one female in the bupropion group who was hospitalized for suicidal ideation during a methamphetamine relapse. Those participants who received bupropion and females in the…
Purpose 2: A Phase 3, Double-Blind, Multicenter, Randomized Study to Evaluate the Efficacy and Safety of Subcutaneous Twice Yearly Long-Acting Lenacapavir for HIV Pre-Exposure Prophylaxis in Cisgender Men, Transgender Women, Transgender Men, and Gender Non-binary People ≥ 16 Years of Age who Have Sex with Male Partners and are at Risk for HIV Infection
RELEVANCE: The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that there were 1.7 million new HIV infections in 2019, despite efforts to improve HIV testing, linkage to treatment, and prevention. Persistent disparities exist in ongoing HIV incidence in Black, Hispanic/LatinX MSM and TGW populations, with the greatest disparities in Black transgender women in the U.S. and with continued low uptake of PrEP in these disproportionately affected populations globally. These barriers clearly highlight the need…
Randomized, Double-Blind, Placebo-Controlled Trial of Monthly Injectable Buprenorphine for Methamphetamine Use Disorder (MURB)
RELEVANCE: The fourth wave of the opioid crisis involves increasing polydrug stimulant and opiate use. Incidence of overdose deaths due to polysubstance use involving opioids co-occurring with methamphetamine increased from 2017 to 2018 by 14.6%. According to the National Survey on Drug Use and Health in 2018, an estimated 1,867,000 of persons in US aged 12 years and older, reported methamphetamine use in the past year and 1,051 000 reported substance use disorder in the…
Randomized, Placebo-Controlled Trial of Bupropion for the Treatment of Methamphetamine Dependence
Randomized, placebo-controlled trial of bupropion for the treatment of methamphetamine dependence DESCRIPTION: This study sought to compare bupropion to placebo for reducing methamphetamine (MA) use, increasing retention, and reducing the severity of depressive symptoms and MA-cravings. Additionally, a secondary objective compared bupropion to placebo for reducing cigarette smoking among MA dependent participants. Following a 2-week, non-medication baseline screening period, 73 treatment-seeking MA dependent participants were randomly assigned to bupropion sustained release (150 mg twice daily;…
Randomized, Placebo-Controlled Trial of Injectable Naltrexone and Monthly Injectable Buprenorphine for Cocaine Use Disorder (CURB-2)
RELEVANCE: Cocaine is one of the most commonly abused stimulants globally, and in the US, there are signs of a resurgence of cocaine use. A variety of pharmacotherapies for cocaine use disorder (CUD) has been explored but so far, no study has findings robust enough to warrant FDA approval. Recent research suggests that a kappa opioid receptor antagonist can curb the negative emotional states associated with stimulant withdrawal that leads to increased craving and drug-seeking behaviors.…
Technology Improving Success of Medication-Assisted Treatment in Primary Care
RELEVANCE: The opioid epidemic is U.S.’s most widespread behavioral public health problem, with a higher number of deaths due to overdose in 2016 compared to deaths due to HIV at the peak of the AIDS epidemic. Medication assisted treatment (MAT) for opioid use disorder (OUD) is highly efficacious. However, only a fraction of persons with OUD access MAT and treatment non-adherence and drop out is common. There is a dire need to improve systems to…
The LA PrEP Stories Project
RELEVANCE: Pre-Exposure Prophylaxis (PrEP) has the potential to reduce the number of new HIV infections among high-risk black and Latino men who have sex with men (BLMSM). However, issues related to the adoption of PrEP may negatively influence PrEP disclosure, diffusion, adherence and retention among BLMSM who adopt PrEP. The findings from this study will inform the development of intervention activities that seeks to prevent or moderate the negative social experiences associated with PrEP adoption…
Varenicline for Methamphetamine Dependence
DESCRIPTION: The goal of this Phase II study is to test the early efficacy of the medication varenicline in treating methamphetamine dependence. The safety and tolerability of varenicline for the treatment of methamphetamine was tested previously and pilot data on the medication’s effectiveness was found to be promising. OUTCOMES: Varenicline was well tolerated, but was not found to be universally efficacious for achieving MA abstinence in this Phase 2 clinical trial. 1. Briones M, Worley…
FREE CONDOMS
According to a 1992 study published in the Journal of Sexually Transmitted Diseases, using a condom makes sex 10,000 times safer than not using a condom. The UCLA Vine Street Clinic has partnered with LA County to provide free condoms to the public. For more information, visit http://lacondom.com/find-free-condoms/