Development of an evidence-based, gay-specific cognitive behavioral therapy intervention for methamphetamine-abusing gay and bisexual men

This study compared outcomes in methamphetamine use and sexual risk behaviors from a modified gay-specific, cognitive behavioral therapy (GCBT) combined with a low-cost contingency management (CM; [GCBT + CM]) intervention to prior findings from clinical trials of the original GCBT. Effect sizes for primary outcomes were compared using meta analysis. Comparisons of effect sizes at end of treatment showed the modified GCBT + CM produced significantly fewer consecutive weeks of methamphetamine abstinence (− 0.44, CI: − 0.79, − 0.09) and fewer male sexual partners (− 0.36, CI: − 0.71, − 0.02) than the first trial of GCBT, and more days of methamphetamine use (0.35, CI: 0.02, 0.68) than the second trial of GCBT. At 26-week follow-up, the modified GCBT + CM produced greater effects in reducing the number of male sexual partners (− 0.54, CI: − 0.89, − 0.19; − 0.51, CI: − 0.84, − 0.18). The original GCBT produced more and mostly short-term beneficial drug use outcomes, though sexual behavior changes consistently favored the modified GCBT + CM. On balance, most benefits are retained with the modified GCBT + CM intervention.

► Aim of the trial was to expand earlier work and adapt into a community setting.
► This study compared outcomes in meth use and sex risk behaviors to prior findings.
► Effect sizes for primary outcomes were compared using meta analysis.
► Meth abuse treatment can function as a part of comprehensive HIV prevention efforts.
► Findings show feasibility of using intervention in community HIV prevention setting.