The purpose of this proposal is to evaluate an intervention that can be readily disseminated and integrated into existing HIV clinics and other community-based organizations (CBOs) offering programs addressing the needs of HIV+ persons with methamphetamine problems. Broadly, this intervention aims to improve the health and quality of life of HIV+ methamphetamine-using men by developing a brief intervention designed to increase HIV medication adherence, decrease methamphetamine use, and positively impact other health related behaviors (sexual risk-taking, other drug use, etc.). Specifically, the proposed randomized clinical trial aims to test the efficacy of a brief, 8-session therapy condition against 8 sessions of education. Additionally, this intervention will test the applicability of Fisher &Fisher's (1992) Information-Motivation-Behavioral Skills (IMB) model to understand changes in adherence and substance use behaviors among HIV+ methamphetamine users. The proposed intervention will target HIV+ methamphetamine-using men in New York City who report less than 90% adherence to their HIV medication regimens. The treatment condition will receive 8 sessions of individually tailored motivational interviewing and cognitive behavioral skills training, while the education (comparison) condition will receive 8 sessions of education surrounding HIV medication adherence, methamphetamine use, and other health-related behaviors (sexual risk-taking, other drug use, etc.). Utilizing several measures of adherence (biological markers, objective, and self-report measures) and methamphetamine use (self-report and biological), this study will test the efficacy of the intervention at 3, 6, 9, and 12 months post-intervention to determine both any immediate and long-lasting effects of the intervention. Additionally, we will consider the mediating role of information, motivation, and behavioral skills to determine the most effective components of this theoretically-based intervention. The findings of this study could help to reduce methamphetamine use and increase HIV medication adherence among HIV+ men. Specifically if effective, the intervention will help minimize the negative physical and psychological effects associated with methamphetamine and improve HIV medication adherence, which has potential effects for survival and health as well as HIV transmission and HIV drug resistance.
