Effects of Contingency Management for Methamphetamine Abstinence on Post-Exposure Prophylaxis for HIV in Men Who Have Sex With Men (MSM) - Full Text View

Purpose

This study seeks to decrease methamphetamine use and concomitant high-risk sexual behaviors among methamphetamine-using men who have sex with men (MSM) by combining a biomedical intervention with a behavioral intervention. The behavioral intervention will consist of an 8-week course of contingency management (CM) through which participants will be reinforced for testing negative for methamphetamine metabolites during periodic urine analyses. The biomedical intervention involves a 28-day course of an antiretroviral drug (Truvada) to be administered after an unanticipated HIV risk exposure (i.e., engaging in either receptive or insertive anal sex without a condom with someone who is HIV-positive or of unknown status). In combining these two interventions, this study seeks to evaluate the combined intervention's effects on sexual risk behaviors and methamphetamine use.

Condition	Intervention	Phase
Amphetamine-Related Disorders HIV HIV Infections	Drug: Truvada Behavioral: CM	Phase 2


Study Type:	Interventional
Study Design:	Endpoint Classification: Safety Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Prevention
Official Title:	Biobehavioral Interventions for HIV-negative Methamphetamine-using MSM

Resource links provided by NLM:

MedlinePlus related topics: HIV/AIDS Methamphetamine

Drug Information available for: Methamphetamine hydrochloride Methamphetamine Truvada

U.S. FDA Resources

Further study details as provided by Friends Research Institute, Inc.:

Primary Outcome Measures:

Self-reported Methamphetamine Use in Previous 30 Days. [ Time Frame: 3-months after baseline ] [ Designated as safety issue: Yes ]
Mean number of days (of the past 30) of methamphetamine use.

Secondary Outcome Measures:

Description of Incident STI Infections. [ Time Frame: Baseline and 3-months ] [ Designated as safety issue: Yes ]
Proportional 3-month incidence of syphilis, rectal gonorrhea, pharyngeal gonorrhea, and rectal Chlamydia.
HIV-related Sexual Risk Behaviors in Previous 30 Days. [ Time Frame: 3-months after baseline ] [ Designated as safety issue: Yes ]
Self-reported episodes of Unprotected Anal Intercourse in the previous 30 days.
Post-Exposure Prophylaxis Medication Adherence [ Time Frame: 28-days ] [ Designated as safety issue: Yes ]
Median medication adherence rate, defined as the proportion of pills taken relative to the number of pills prescribed (i.e., # of pills taken / # of pills prescribed).


Enrollment:	53
Study Start Date:	January 2009
Study Completion Date:	December 2010
Primary Completion Date:	December 2010 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: PEP/CM	Drug: Truvada At qualifying exposure, participants will take 28 days' worth (at one pill per day) of 200 mg emtricitabine and 300 mg tenofovir DF (Truvada). Other Names: Truvada Emtricitabine and tenofovir disoproxil fumarate Behavioral: CM Participants will submit a urine sample every Monday, Wednesday, and Friday for 8 weeks (a total of 24 urine samples). Samples will be tested for methamphetamine metabolites. Other Names: Contingency Management CM

Arms

Assigned Interventions

Experimental: PEP/CM

Drug: Truvada

At qualifying exposure, participants will take 28 days' worth (at one pill per day) of 200 mg emtricitabine and 300 mg tenofovir DF (Truvada).

Other Names:

Truvada
Emtricitabine and tenofovir disoproxil fumarate

Behavioral: CM

Participants will submit a urine sample every Monday, Wednesday, and Friday for 8 weeks (a total of 24 urine samples). Samples will be tested for methamphetamine metabolites.

Other Names:

Contingency Management
CM

Eligibility


Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Male
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Individual must identify as a male who has sex with other men (MSM);
At least 18 years of age;
HIV negative serostatus on baseline rapid oral HIV antibody test;
Self-reported methamphetamine use within the previous 72 hours and test positive for methamphetamine metabolites at baseline;
Self-reported unprotected anal intercourse (either receptive or insertive) with an HIV-positive or status unknown partner within the previous 3 months;
Self-reports no previous hypersensitivity to any of the components of Truvada (tenofovir disoproxil fumarate or emtricitabine);
Willing to comply with study requirements (i.e., monitored urine testing three times per week, meet with physician within first week of enrollment, begin medication immediately following an unexpected high-risk sexual exposure, and contact the clinic and meet with physician within 92 hours of unexpected high-risk sexual exposure).

Exclusion Criteria:

Does not identify as a male who has sex with other men;
Under 18 years of age;
HIV positive, by self-report or as indicated by the results on the baseline rapid oral HIV antibody test;
Self-reports any previous hypersensitivity to any of the components of Truvada;
Has not used methamphetamine in the previous 72 hours and does not test positive for methamphetamine metabolites;
Has not had unprotected anal intercourse with an HIV-positive or status unknown partner within the previous 3 months;
Unwilling to comply with study requirements.

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00856323

Locations


United States, California
Friends Community Center
Los Angeles, California, United States, 90028

Sponsors and Collaborators

Friends Research Institute, Inc.

University of California, Los Angeles

Investigators


Principal Investigator:	Cathy J Reback, Ph.D.	Friends Research Institute, Inc.
Principal Investigator:	Raphael J Landovitz, M.D.	UCLA Center for Clinical AIDS Research and Education
Principal Investigator:	Steve Shoptaw, Ph.D.	UCLA Department of Family Medicine

More Information

Publications:

Landovitz RJ, Fletcher JB, Inzhakova G, Lake JE, Shoptaw S, Reback CJ. A novel combination HIV prevention strategy: post-exposure prophylaxis with contingency management for substance abuse treatment among methamphetamine-using men who have sex with men. AIDS Patient Care STDS. 2012 Jun;26(6):320-8. doi: 10.1089/apc.2011.0432.


Responsible Party:	Cathy Reback, Principal Investigator, Friends Research Institute, Inc.
ClinicalTrials.gov Identifier:	NCT00856323 History of Changes
Other Study ID Numbers:	702632
Study First Received:	March 3, 2009
Results First Received:	August 27, 2012
Last Updated:	November 27, 2012
Health Authority:	United States: Food and Drug Administration

Keywords provided by Friends Research Institute, Inc.:


Methamphetamine HIV Post-exposure prophylaxis HIV seronegativity

Additional relevant MeSH terms:


Amphetamine-Related Disorders Chemically-Induced Disorders Mental Disorders Substance-Related Disorders Methamphetamine Adrenergic Agents Adrenergic Uptake Inhibitors Autonomic Agents Central Nervous System Agents Central Nervous System Stimulants	Dopamine Agents Dopamine Uptake Inhibitors Molecular Mechanisms of Pharmacological Action Neurotransmitter Agents Neurotransmitter Uptake Inhibitors Peripheral Nervous System Agents Pharmacologic Actions Physiological Effects of Drugs Sympathomimetics Therapeutic Uses

ClinicalTrials.gov processed this record on March 02, 2015