Document Detail

A pilot trial of integrated behavioral activation and sexual risk reduction counseling for HIV-uninfected men who have sex with men abusing crystal methamphetamine.
MedLine Citation:
PMID:  23030605     Owner:  NLM     Status:  MEDLINE    
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 χ(2)=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 (χ(2)=22.43; df=2,15; p<0.0001), and the number of days of crystal methamphetamine use in the past 30 days (χ(2)=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.
Matthew J Mimiaga; Sari L Reisner; David W Pantalone; Conall O'Cleirigh; Kenneth H Mayer; Steven A Safren
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural     Date:  2012-10-03
Journal Detail:
Title:  AIDS patient care and STDs     Volume:  26     ISSN:  1557-7449     ISO Abbreviation:  AIDS Patient Care STDS     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-08     Completed Date:  2013-04-02     Revised Date:  2013-11-05    
Medline Journal Info:
Nlm Unique ID:  9607225     Medline TA:  AIDS Patient Care STDS     Country:  United States    
Other Details:
Languages:  eng     Pagination:  681-93     Citation Subset:  IM; X    
Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
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MeSH Terms
Central Nervous System Stimulants*
Confidence Intervals
Depression / epidemiology,  prevention & control*,  psychology
Drug Users*
HIV Infections / epidemiology,  prevention & control*,  psychology
Health Knowledge, Attitudes, Practice
Homosexuality, Male* / psychology
Middle Aged
Pilot Projects
Risk Reduction Behavior*
Safe Sex
Sex Counseling*
Sexual Behavior
Sexual Partners* / psychology
Grant Support
Reg. No./Substance:
0/Central Nervous System Stimulants; 537-46-2/Methamphetamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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