Development of a methamphetamine early intervention

描述（由申请人提供）：甲基苯丙胺滥用与高风险性行为以及男男性行为者（MSM）中的流行和事件HIV具有强烈且一致的流行病学关联，一些当局提倡将甲基苯丙胺治疗作为HIV预防策略。然而，甲基苯丙胺干预措施尚未在对照试验中进行评估，也没有在药物滥用治疗计划之外实施和评估。本申请提出了初步调查，以适应甲基苯丙胺治疗干预以前与减少性风险之间的MSM作为一个早期干预的MSM之间招募的性传播疾病（STD）诊所在西雅图，华盛顿。60名使用甲基苯丙胺的男男性行为者将参加一项随机对照试验，比较应急管理（CM）与不干预。CM受试者将每周进行3次甲基苯丙胺尿液检测，持续12周，当尿液检测结果为阴性时，将收到价值递增的代金券;当受试者的尿液检测结果为甲基苯丙胺阳性或受试者错过尿液检测访视时，将扣留代金券。所有参与者将在基线和6周间隔6个月接受尿液甲基苯丙胺检测和音频计算机辅助的性行为和物质使用自我访谈。参与者将在基线以及3个月和6个月随访时接受HIV、梅毒、直肠淋病和衣原体感染以及咽部淋病检测。该研究将确定MSM就诊STD诊所的频率，并将启动和完成早期干预，并将纵向测量干预和控制参与者的不安全性行为。研究结果将确定制定和研究CM作为早期干预措施的可行性;确定干预措施是否有足够的前景来证明更大的，明确的随机对照试验的合理性;并将提供估计，以确定此类试验所需的参与者人数。

DESCRIPTION (provided by applicant): Methamphetamine abuse has a strong and consistent epidemiologic association with high-risk sexual behavior and both prevalent and incident HIV in men who have sex with men (MSM), and some authorities have advocated methamphetamine treatment as an HIV prevention strategy. However, methamphetamine interventions have not been evaluated in controlled trials, nor have they been implemented and assessed outside of substance abuse treatment programs. This application proposes preliminary investigations to adapt a methamphetamine treatment intervention previously associated with decreased sexual-risk taking among MSM for use as an early intervention among MSM recruited from sexually transmitted disease (STD) clinics in Seattle, Washington. Sixty methamphetamine-using MSM attending STD clinics will be enrolled in a randomized controlled trial of contingency management (CM) versus no intervention. CM participants will have their urine tested for methamphetamine 3 times weekly for 12 weeks, and will receive vouchers of escalating value when their urines test negative; vouchers will be withheld when participants' urines test positive for methamphetamine or participants miss urine testing visits. All participants will undergo urine methamphetamine testing and audio-computer assisted self-interviews on sexual behavior and substance use at baseline and at 6 week intervals for 6 months. Participants will be tested for HIV, syphilis, rectal gonorrhea and chlamydial infection, and pharyngeal gonorrhea at baseline and at 3 and 6 month follow-up. The study will determine how often MSM attending STD clinics will initiate and complete the early intervention, and will longitudinally measure unsafe sexual behaviors among intervention and control participants. Study results will determine the feasibility of instituting and studying CM as an early intervention; define whether the intervention is sufficiently promising to justify a larger, definitive randomized controlled trial; and will provide estimates for defining the number of participants such a trial would require.