Randomized controlled trial of a positive affect intervention for methamphetamine users

Adam W Carrico, Walter Gόmez, Jennifer Jain, Steven Shoptaw, Michael V Discepola, David Olem, Justin Lagana-Jackson, Rick Andrews, Torsten B Neilands, Samantha E Dilworth, Jennifer L Evans, William J Woods, Judith T Moskowitz, Adam W Carrico, Walter Gόmez, Jennifer Jain, Steven Shoptaw, Michael V Discepola, David Olem, Justin Lagana-Jackson, Rick Andrews, Torsten B Neilands, Samantha E Dilworth, Jennifer L Evans, William J Woods, Judith T Moskowitz

Abstract

Background: Contingency management (CM) is an evidence-based intervention providing rewards in exchange for biomarkers that confirm abstinence from stimulants such as methamphetamine. We tested the efficacy of a positive affect intervention designed to boost the effectiveness of CM with HIV-positive, methamphetamine-using sexual minority men.

Methods: This attention-matched, randomized controlled trial of a positive affect intervention delivered during CM was registered on www.clinicaltrials.gov (NCT01926184). In total, 110 HIV-positive sexual minority men with biologically confirmed, recent methamphetamine use were enrolled. Five individual sessions of a positive affect intervention (n = 55) or an attention-control condition (n = 55) were delivered during three months of CM. Secondary outcomes examined over the 3-month intervention period included: 1) psychological processes relevant to affect regulation (i.e., positive affect, negative affect, and mindfulness); 2) methamphetamine craving; 3) self-reported stimulant use (past 3 months); and 4) cumulative number of urine samples that were non-reactive for stimulants (i.e., methamphetamine and cocaine) during CM.

Results: Those randomized to the positive affect intervention reported significant increases in positive affect during individual sessions and increases in mindfulness over the 3-month intervention period. Intervention-related improvements in these psychological processes relevant to affect regulation were paralleled by concurrent decreases in methamphetamine craving and self-reported stimulant use over the 3-month intervention period.

Conclusions: Delivering a positive affect intervention may improve affect regulation as well as reduce methamphetamine craving and stimulant use during CM with HIV-positive, methamphetamine-using sexual minority men.

Keywords: Contingency management; HIV; Men who have sex with men; Methamphetamine; Mindfulness; Positive affect.

Conflict of interest statement

Conflicts of Interest

No conflict of declared.

Copyright © 2018 Elsevier B.V. All rights reserved.

Figures

Figure 1.
Figure 1.
Screening, randomization, and follow-up for participants.

Source: PubMed

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