55 Participants Needed

Contingency Management for Methamphetamine Use in HIV/AIDS

(EXPRESS+ Trial)

MJ
Overseen ByMichael J Li, PhD
Age: 18 - 65
Sex: Male
Trial Phase: Academic
Sponsor: University of California, Los Angeles
Must be taking: Antiretrovirals
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 2 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This is a non-randomized behavioral trial that aims to investigate whether changes in inflammatory and type I IFN expression coincide with changes in methamphetamine use and viral load over the course of 12 weeks in HIV-positive people assigned male at birth with and without methamphetamine use disorder.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, you must have a current antiretroviral prescription to participate.

Is Contingency Management safe for humans?

Contingency Management, which uses rewards to encourage positive behavior, has been studied for various substance use disorders and generally shows no significant safety concerns. Studies have shown it to be effective in reducing drug use and risky behaviors without increasing drug use when cash incentives are used.12345

How is the treatment Contingency Management different from other treatments for methamphetamine use in HIV/AIDS?

Contingency Management is unique because it uses rewards to encourage people to stop using methamphetamine, which can lead to greater drug abstinence and reduced risky behaviors. Unlike other treatments, it directly ties positive behavior changes to tangible incentives, making it particularly effective in outpatient settings.56789

What data supports the effectiveness of the treatment Contingency Management for Methamphetamine Use in HIV/AIDS?

Research shows that Contingency Management, which uses rewards like vouchers or prizes to encourage drug abstinence, has been effective in reducing cocaine and opioid use among methadone patients. Patients in these programs achieved longer periods of abstinence, suggesting that similar methods could help reduce methamphetamine use in individuals with HIV/AIDS.310111213

Who Is on the Research Team?

MJ

Michael J Li, PhD

Principal Investigator

UCLA Department of Family Medicine

Are You a Good Fit for This Trial?

This trial is for HIV-positive males aged 18-45 who have sex with men and are seeking treatment for methamphetamine use disorder. Participants must be on antiretroviral therapy, test positive for meth within 30 days before screening, and can attend bi-weekly appointments. Those using opioids, cocaine, MDMA or identifying as female cannot join.

Inclusion Criteria

I am a male, aged 18-45, HIV-positive, have sex with men, and am on antiretroviral treatment.

Exclusion Criteria

I am a female who has used substances like meth, opioids, cocaine, or MDMA in the last 6 months.
I identify as female, have a substance use disorder, and may be in another trial or tested positive for certain drugs.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants in the contingency management group receive treatment for methamphetamine use disorder with escalating rewards for negative urine tests

8 weeks
16 visits (in-person, twice weekly)

Observation

Non-substance-using control group participants have observational visits

12 weeks
4 visits (in-person, every 4 weeks)

Follow-up

Participants are monitored for changes in methamphetamine use, viral load, and gene expression

4 weeks
1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

  • Contingency Management
Trial Overview The EXPRESS+ study examines if changes in stress markers align with shifts in meth use and viral load over a period of 12 weeks among HIV-positive individuals assigned male at birth who do or don't have a methamphetamine use disorder.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Contingency Management for Methamphetamine ReductionExperimental Treatment1 Intervention
Group II: Non-substance-using ControlActive Control1 Intervention

Contingency Management is already approved in United States, European Union for the following indications:

🇺🇸
Approved in United States as Contingency Management for:
🇪🇺
Approved in European Union as Contingency Management for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of California, Los Angeles

Lead Sponsor

Trials
1,594
Recruited
10,430,000+

National Institute on Drug Abuse (NIDA)

Collaborator

Trials
2,658
Recruited
3,409,000+

Published Research Related to This Trial

In a study involving 74 cocaine-dependent methadone outpatients over 12 weeks, both voucher and prize-based contingency management (CM) interventions led to longer durations of abstinence compared to standard treatment.
The study found no significant differences in outcomes between the voucher and prize systems, indicating that both methods are effective in promoting abstinence during treatment, which is linked to better long-term recovery outcomes.
Randomized trial of contingent prizes versus vouchers in cocaine-using methadone patients.Petry, NM., Alessi, SM., Hanson, T., et al.[2021]
A low-cost contingency management (CM) procedure significantly improved continuous abstinence from cocaine and opioids among 42 methadone patients over a 12-week treatment period, compared to standard treatment alone.
Patients in the CM group not only achieved longer periods of abstinence but also maintained these effects for 6 months after treatment, earning an average of $137 in prizes, indicating the potential effectiveness of this approach in community settings.
Low-cost contingency management for treating cocaine- and opioid-abusing methadone patients.Petry, NM., Martin, B.[2019]
In a study involving 142 outpatients with cocaine or heroin dependence, both voucher and prize-based contingency management (CM) interventions led to longer treatment retention and greater durations of confirmed abstinence compared to standard treatment.
While there were no significant differences in abstinence rates at 6- and 9-month follow-ups, the duration of abstinence achieved during treatment was the strongest predictor of continued abstinence after treatment ended.
Vouchers versus prizes: contingency management treatment of substance abusers in community settings.Petry, NM., Alessi, SM., Marx, J., et al.[2016]

Citations

Randomized trial of contingent prizes versus vouchers in cocaine-using methadone patients. [2021]
Low-cost contingency management for treating cocaine- and opioid-abusing methadone patients. [2019]
Vouchers versus prizes: contingency management treatment of substance abusers in community settings. [2016]
Shaping cocaine abstinence by successive approximation. [2019]
Is exposure to an effective contingency management intervention associated with more positive provider beliefs? [2021]
Contingency management in cocaine abusers: a dose-effect comparison of goods-based versus cash-based incentives. [2022]
Contingency management to reduce methamphetamine use and sexual risk among men who have sex with men: a randomized controlled trial. [2022]
Contingency Management Abstinence Incentives: Cost and Implications for Treatment Tailoring. [2019]
Contingency management for the treatment of methamphetamine use disorder: A systematic review. [2021]
An autoregressive cross-lagged model unraveling co-occurring stimulant use and HIV: Results from a randomized controlled trial. [2022]
Contingency management: an evidence-based component of methamphetamine use disorder treatments. [2019]
Contingency management: schedule effects. [2013]
13.United Statespubmed.ncbi.nlm.nih.gov
Contingency management for the treatment of methamphetamine use disorders. [2022]
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