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

• Published in: AIDS and behavior 2018-08, Vol.22 (8), p.2674-2686
• Main Authors: Parsons, Jeffrey T., John, Steven A., Millar, Brett M., Starks, Tyrel J.
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adhesion; Adult; AIDS; Amphetamine-Related Disorders - therapy; Anal intercourse; Anal sex; Anti-Retroviral Agents - therapeutic use; Bisexuality; CD4 antigen; CD4 Lymphocyte Count; Cognition; Cognitive ability; Cognitive Behavioral Therapy; Condoms - statistics & numerical data; Drug abuse; Drugs; Gays & lesbians; Health Psychology; HIV; HIV Infections - blood; HIV Infections - drug therapy; Homosexuality; Homosexuality, Male; Human immunodeficiency virus; Humans; Infectious Diseases; Intervention; Interviews; Male; Medication Adherence; Medicine; Medicine & Public Health; Men; Mens health; Methamphetamine; Middle Aged; Motivation; Motivational Interviewing; Original Paper; Patient compliance; Public Health; Randomization; Risk Reduction Behavior; Sexual and Gender Minorities; Sexual Behavior - statistics & numerical data; Sexually transmitted diseases; Skills; STD; Subgroups; Training; Viral Load; Young Adult
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-018-2086-5

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.