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Drug Alcohol Depend. 2018 Nov 1;192:8-15. doi: 10.1016/j.drugalcdep.2018.07.029. Epub 2018 Sep 5.

Randomized controlled trial of a positive affect intervention for methamphetamine users.

Author information

1
Department of Public Health Sciences, University of Miami School of Medicine, 1120 NW 14th St., Office 1005, Miami, FL 33136 USA. Electronic address: a.carrico@miami.edu.
2
Berkeley School of Social Welfare, University of California, 120 Haviland Hall, #7400, Berkeley, CA 94720 USA.
3
Department of Medicine, Division of Global Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 902093 USA.
4
Departments of Family Medicine and Psychiatry, David Geffen School of Medicine, University of California, Los Angeles, 10080 Wilshire Blvd., Los Angeles, CA 900024 USA.
5
San Francisco AIDS Foundation, 1035 Market Street, Suite 400, San Francisco, CA 94103 USA.
6
University of California, San Francisco School of Medicine, Box 0886, 550 16th Street, 3469, San Francisco, CA 94158 USA.
7
Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 633 N. Saint Clair St., 19th Floor, Chicago, IL 60611 USA.

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

PMID:
30195243
PMCID:
PMC6200638
[Available on 2019-11-01]
DOI:
10.1016/j.drugalcdep.2018.07.029
[Indexed for MEDLINE]

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