Testing the Efficacy of Combined Motivational Interviewing and Cognitive Behavioral Skills Training to Reduce Methamphetamine Use and Improve HIV Medication Adherence Among HIV-Positive Gay and Bisexual Men

AIDS Behav. 2018 Aug;22(8):2674-2686. doi: 10.1007/s10461-018-2086-5.

Abstract

Prior research has identified subgroups of HIV-positive gay and bisexual men (GBM) based upon information, motivation, and behavioral skills (IMB) profiles related to HIV medication adherence and methamphetamine use. We conducted a randomized controlled trial of a combined motivational interview (MI) and cognitive behavioral therapy (CBT) intervention tailored specifically to the unique context of HIV-positive GBM, and tested whether IMB profiles moderated treatment effects. HIV-positive GBM (N = 210) were randomized to MI + CBT or an attention-matched education control. Both conditions resulted in reduced methamphetamine use, improved medication adherence (and higher CD4 and lower viral loads), and fewer acts of condomless anal sex at 3, 6, 9 and 12 months post-intervention. Furthermore, the MI + CBT condition achieved greater improvements in medication adherence for men who had greater barriers to change compared to similarly-classified men in the control condition, suggesting the importance of pre-intervention profiles for tailoring future interventions.

Keywords: Crystal methamphetamine; Drug intervention; HIV; IMB model; Men who have sex with men (MSM).

MeSH terms

  • Adult
  • Amphetamine-Related Disorders / therapy*
  • Anti-Retroviral Agents / therapeutic use*
  • Bisexuality
  • CD4 Lymphocyte Count
  • Cognitive Behavioral Therapy*
  • Condoms / statistics & numerical data
  • HIV Infections / blood
  • HIV Infections / drug therapy*
  • Homosexuality, Male
  • Humans
  • Male
  • Medication Adherence*
  • Methamphetamine
  • Middle Aged
  • Motivational Interviewing*
  • Risk Reduction Behavior
  • Sexual Behavior / statistics & numerical data
  • Sexual and Gender Minorities*
  • Viral Load
  • Young Adult

Substances

  • Anti-Retroviral Agents
  • Methamphetamine