Stimulant Abuse Clinical Trial
Official title:
Optimizing Access to Non-occupational Post Exposure Prophylaxis for HIV Using Contingency Management in Stimulant-Using Men Who Have Sex With Men
This study seeks to evaluate the efficacy of a contingency management (CM) intervention compared to a yoked control condition for eliminating illicit stimulant use and for decreasing time to initiating post exposure prophylaxis (PEP), for improving adherence to PEP, and for completing PEP following a potential HIV-exposure event. Men who have sex with men who use cocaine amphetamine or methamphetamine frequently also have high risk sexual behaviors during or after their drug use. The objective of this study evaluates whether the use of CM that targets stimulant use significantly aids men who have sex with men who use stimulants and also engage in high-risk sexual transmission behaviors to be able to initiate, adhere to and complete PEP, thereby optimizing the utility of a biomedical HIV prevention intervention for reducing HIV incidence in this very high-risk group of MSM.
This was a prospective, randomized study. 170 participants who met inclusion and exclusion
criteria were randomized to CM or NCYC (non-contingent yoked-control condition) arms. They
were provided with a 4-day starter-pack of PEP medication (tenofovir + emtricitabine,
Truvada) to be started only in the event of a high-risk sexual exposure. The two
interventions were implemented simultaneously:
The CM or NCYC intervention, remunerating (via vouchers) the participant based on his own
(CM) or a yoked-participant's (NCYC) stimulant-metabolite-free urine samples for 8 weeks;
and,
Post-exposure prophylaxis, providing risk reduction counseling, adherence counseling and PEP
medication for 28 days in the event of a high-risk sexual exposure to HIV.
All participants were followed for 24 weeks, or 24-weeks post-HIV-exposure, whichever was
longer.
;
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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