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 networks have only been partially evaluated. The intersection of substance use, sexual risk behavior, and HIV transmission in MSM networks presents a critical problem for contemporary HIV prevention as HIV-uninfected MSM who use MA have a 16%-33% attributable risk for HIV infection, while only approximately 50% of HIV-infected MA-using MSM achieve and maintain virologic suppression.
DESCRIPTION: This study will compare different CM models of HIV status-neutral approaches to integrate substance use treatment with HIV prevention among MA-using MSM: Traditional CM targeted to MA abstinence and alternative CM based on ARV adherence in order to assess the logistics, feasibility, and preliminary estimates of effect of CM for ARV adherence.
STATUS: This project is currently in the data analysis phase.