Contingency Management in HIV Care for Both Stimulant Use & ART Adherence

NCT06564792 | Completed

• 1 other identifier: 23-38747
• Study Type: interventional
• Target: 37
• Locations: 1 country
• Sites: 1

Brief Summary

Methamphetamine use and associated sequelae have been rising, and represent a major barrier to successful control of the HIV epidemic. Methamphetamine use is associated with poor adherence to antiretroviral therapy for HIV, and the investigators propose a trial of contingency management (providing incentives for behavioral change) targeting both reduced methamphetamine use and improved adherence to HIV medications. The investigators will utilize a real-time, point-of-care urine assay for both outcomes, aiming to evaluate feasibility, acceptability and preliminary effectiveness of HIV care-based contingency management. Hair levels will also be studied as a quantitative outcome for reduction in methamphetamine use.

Conditions

Stimulant Use (Diagnosis); Hiv

Outcome Measures

Primary Outcomes (2)

• Feasibility: proportion of CM visits attended

  The investigators will report multiple process measures as feasibility outcomes, though primary outcome is the number and proportion of contingency management visits attended (of 12). It is expected that 50% of participants will attend at least 6 or more CM visits, which is defined as minimum engagement suggesting feasibility of this HIV primary care-based CM intervention.

  Measured during intervention participation.

• Acceptability: in-depth interviews with participants, staff

  The investigators will conduct in-depth qualitative interviews to understand factors and circumstances that influence CM engagement among PWH with stimulant use disorder and suboptimal ART adherence. These findings will also help elucidate mechanisms contributing to stimulant use reduction and ART adherence when once weekly CM is delivered to PWH in a designated primary care setting.

  Interviews performed within 6 months of intervention participation.

Secondary Outcomes (2)

• Effectiveness (Urine)

  Measured during intervention participation.

• Effectiveness (Hair)

  Analyzed within 1 year following hair collection

Study Arms (1)

Contingency management arm

EXPERIMENTAL

Participants are offered once weekly contingency management in clinic to support reduced stimulant use and HIV medication adherence.

Behavioral: Contingency management

Interventions

Contingency management BEHAVIORAL

Once weekly contingency management visit involving 15 minutes+ of motivational interviewing and provision of incentives for stimulant-negative urine tests and/or tenofovir-positive urine tests.

Contingency management arm

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Stimulant use disorder
• Living with HIV or risk for HIV
• Suboptimal ART adherence (treatment or prevention)

You may not qualify if:

• Unable to provide urine testing weekly

Sponsors & Collaborators

• University of California, San Francisco: lead

Study Sites (1)

UCSF at San Francisco General Hospital

San Francisco, California, 94110, United States

Location

Related Publications (1)

• Steiner G, Baral S, Riley ED, Shoptaw S, Chamie G, Roberts K, Suchman L, Knight K, Gandhi M, Coffin P, Appa A. Harm Reduction Contingency Management for Stimulant Use Reduction and Antiretroviral Therapy Adherence in HIV Primary Care: Protocol for an Implementation Effectiveness Study. JMIR Res Protoc. 2025 Aug 18;14:e67292. doi: 10.2196/67292.

  PMID: 40825537 DERIVED

MeSH Terms

Conditions

Disease; Acquired Immunodeficiency Syndrome

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms; HIV Infections; Blood-Borne Infections; Communicable Diseases; Infections; Sexually Transmitted Diseases, Viral; Sexually Transmitted Diseases; Lentivirus Infections; Retroviridae Infections; RNA Virus Infections; Virus Diseases; Slow Virus Diseases; Genital Diseases; Urogenital Diseases; Immunologic Deficiency Syndromes; Immune System Diseases

Study Officials

• Ayesha Appa, MD

  University of California, San Francisco

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 19, 2024
• First Posted: August 21, 2024
• Study Start: September 15, 2023
• Primary Completion: May 30, 2024
• Study Completion: October 1, 2025
• Last Updated: October 14, 2025

Record last verified: 2025-10

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)