Increased numbers of HIV/AIDS cases among Men who have Sex with Men (MSM) have been linked to the use of methamphetamine - a powerful stimulant that is widely used across the USA. Studies conducted with MSM from San Diego to New York show a strong association between methamphetamine use and high risk sexual practices. Heightened concerns about the spread of HIV/AIDS among MSM has led to an immediate need for the development of sexual risk reduction interventions for HIV+ methamphetamine users. A major goal of intervention development is to give priority to the sustainability of behavior change as well as initial behavior change. The primary objective of this study is to evaluate the efficacy of a behavioral intervention that integrates an individual behavior change component with a behavioral maintenance component, which together are hypothesized to result in maximum, long-term treatment effects. Our intervention will utilize a randomized, pretest, multiple posttest, control group design. Three hundred sexually active HIV+ MSM who regularly use methamphetamine and who have had unprotected sex with HIV negative or unknown status partner(s) will be randomly assigned to one of two conditions: 1) individual behavior change plus group- format maintenance counseling program or 2) an attention-control condition (time-equivalent to condition 1) which addresses diet, exercise, and HIV. The behavior change component of the intervention (based on social cognitive theory, cognitive behavioral therapy, and the theory of reasoned action) addresses five intervention domains: the context of unsafe sex/drug use;condom use, negotiation of safer sex practices, disclosure of HIV seropositivity to sex partners, and enhancement of social supports. The eight session group-format safer sex maintenance component of the program will use clinical strategies borrowed from relapse prevention to help participants sustain or improve positive behavioral changes (e.g., maintenance involves identifying high risk situations that can lead to sexual slipups, developing effective coping strategies). Followup assessments will be conducted at 6-, 12- and 18-months. A variety of outcomes will be examined (e.g., unprotected anal sex, number of HIV- partners, partner types). Subgroup differences in the efficacy of the intervention based on ethnicity, patterns of drug use (e.g., binge use, injection, polydrug use) and key psychosocial factors (e.g., sexual compulsivity, experiences of abuse) will be explored.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA021115-05
Application #
7810579
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Jenkins, Richard A
Project Start
2006-09-30
Project End
2012-04-30
Budget Start
2010-05-01
Budget End
2012-04-30
Support Year
5
Fiscal Year
2010
Total Cost
$539,954
Indirect Cost
Name
University of California San Diego
Department
Psychiatry
Type
Schools of Medicine
DUNS #
804355790
City
La Jolla
State
CA
Country
United States
Zip Code
92093
Grant, Igor; Franklin Jr, Donald R; Deutsch, Reena et al. (2014) Asymptomatic HIV-associated neurocognitive impairment increases risk for symptomatic decline. Neurology 82:2055-62
Semple, Shirley J; Strathdee, Steffanie A; Zians, Jim et al. (2012) Mother-son relationship as a risk factor for depressive symptoms among methamphetamine users. J Subst Use 17:51-60
Semple, Shirley J; Strathdee, Steffanie A; Zians, Jim et al. (2012) Factors associated with experiences of stigma in a sample of HIV-positive, methamphetamine-using men who have sex with men. Drug Alcohol Depend 125:154-9
Nakamura, Nadine; Semple, Shirley J; Strathdee, Steffanie A et al. (2011) HIV risk profiles among HIV-positive, methamphetamine-using men who have sex with both men and women. Arch Sex Behav 40:793-801
Semple, Shirley J; Strathdee, Steffanie A; Zians, Jim et al. (2011) Psychosocial and behavioral correlates of anxiety symptoms in a sample of HIV-positive, methamphetamine-using men who have sex with men. AIDS Care 23:628-37
Nakamura, Nadine; Mausbach, Brent T; Ulibarri, Monica D et al. (2011) Methamphetamine use, attitudes about condoms, and sexual risk behavior among HIV-positive men who have sex with men. Arch Sex Behav 40:267-72
Semple, Shirley J; Strathdee, Steffanie A; Zians, Jim et al. (2011) Correlates of obsessive-compulsive disorder in a sample of HIV-positive, methamphetamine-using men who have sex with men. AIDS Behav 15:1153-60
Semple, Shirley J; Strathdee, Steffanie A; Zians, Jim et al. (2011) Drug assertiveness and sexual risk-taking behavior in a sample of HIV-positive, methamphetamine-using men who have sex with men. J Subst Abuse Treat 41:265-72
Nakamura, Nadine; Zea, Maria Cecilia (2010) Experiences of homonegativity and sexual risk behaviour in a sample of Latino gay and bisexual men. Cult Health Sex 12:73-85
Heaton, R K; Clifford, D B; Franklin Jr, D R et al. (2010) HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy: CHARTER Study. Neurology 75:2087-96

Showing the most recent 10 out of 17 publications