NCT06814275

Brief Summary

The purpose of this research is to understand how chronic stress affects the way our brain and immune systems function, and in turn how this affects the way people feel, think, and behave. By learning more about how these processes work, the hope is to be able to develop better treatments to help with problems like depression and substance use. This study is intended for individuals that are HIV positive, currently taking prescription antiretroviral medications, and use stimulants. Through this intervention, the aim is to determine if this positive affect intervention can lead to reductions in stimulant use and depressed mood.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
189

participants targeted

Target at P75+ for not_applicable

Timeline
33mo left

Started Apr 2025

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress28%
Apr 2025Dec 2028

First Submitted

Initial submission to the registry

February 3, 2025

Completed
4 days until next milestone

First Posted

Study publicly available on registry

February 7, 2025

Completed
3 months until next milestone

Study Start

First participant enrolled

April 29, 2025

Completed
3.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 31, 2028

Expected
7 months until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2028

Last Updated

September 11, 2025

Status Verified

September 1, 2025

Enrollment Period

3.1 years

First QC Date

February 3, 2025

Last Update Submit

September 10, 2025

Conditions

Keywords

HIVStimulant usesubstance abusechronic stress

Outcome Measures

Primary Outcomes (2)

  • Neural Functional Connectivity

    Functional connectivity (FC) will be derived from the the resting-state functional MRI data. Using a theory-driven, seed-based approach, the 4D time series \[average blood oxygenation level dependent (BOLD) signal across voxels\] will be extracted from a priori seeds in the reward network (i.e., nucleus accumbens, subgenual anterior cingulate cortex, medial orbitofrontal cortex). Normalized Z-scores will be calculated for FC between regions of interest. These analyses will control for baseline FC.

    Month 3

  • Neural Activation

    The Monetary Incentive Delay Task will be used to probe neural activation to reward processing, using an event-level design. Blood oxygenation level dependent (BOLD) activation will be modeled as a canonical hemodynamic response function specified at stimulus onset. Event epochs that are time locked to the onset of each trial will be extracted from the overall time series. Random-effects general linear model will be used to calculate statistical parametric maps reflecting the probability that a voxel is activated as a function of the experimental task. The primary analysis will focus on nucleus accumbens and ventromedial prefrontal cortex activity as regions of interest (ROI). Mean beta values will be averaged across all voxels in each ROI. These analyses will control for baseline activation levels.

    Month 3

Secondary Outcomes (4)

  • Change in Frequency of Stimulant Use

    3 and 6 month follow-ups

  • Depression Scores

    3 and 6 month follow-ups

  • CTRA Leukocyte Signaling

    Baseline, Month 3, Month 6

  • Change in Peripheral Inflammation

    3 and 6 month follow-ups

Study Arms (2)

ARTEMIS

ACTIVE COMPARATOR

Participants in this arm will receive the ARTEMIS intervention immediately following randomization.

Behavioral: ARTEMISBehavioral: Contingency management for Antiretroviral (ARV) adherence

Waitlist Control (WLC)

OTHER

Participants in the WLC arm will be offered the ARTEMIS intervention after the final (6-month) follow-up.

Behavioral: Contingency management for Antiretroviral (ARV) adherence

Interventions

ARTEMISBEHAVIORAL

The ARTEMIS intervention includes 5 sessions delivered individually over Zoom across 3 months. The intervention teaches 9 positive affect skills: noting and capitalizing on positive events, gratitude journaling, formal and informal mindfulness, positive reappraisal and problem solving coping skills training, focusing on personal strengths, setting achievable goals, and small acts of kindness. Each session consists of a didactic portion with in vivo skills practice, and participants are asked to complete daily home practice of the skills between sessions.

ARTEMIS

All participants will received the contingency management (CM) intervention to support ARV adherence. They will use the Spotlight by Scene Health platform, a HIPAA-compliant mHealth application for directly observed therapy, to upload videos of ART adherence. The app records and uploads time-stamped videos of medication doses, which staff verify asynchronously. Participants will be paid for each verified dose and receive a weekly bonus if they complete 6 doses.

ARTEMISWaitlist Control (WLC)

Eligibility Criteria

Age18 Years - 59 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)

You may qualify if:

  • years old
  • Weekly use of stimulants reported in the past month or a score of 4 or more on the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)
  • Confirmed HIV diagnosis
  • Current receipt of daily oral antiretroviral therapy (ART) medication
  • English fluency/literacy

You may not qualify if:

  • Acute brain infection (e.g., neurosyphilis, toxoplasmosis)
  • Acutely symptomatic bipolar I or psychotic disorder
  • Prescription for immunomodulatory medications or other immunotherapy
  • Any MRI contraindications
  • If applicable, on antidepressant medication regimen for at least 2 months

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Wake Forest University School of Medicine

Winston-Salem, North Carolina, 27101, United States

RECRUITING

MeSH Terms

Conditions

Acquired Immunodeficiency SyndromeDepressionSubstance-Related Disorders

Interventions

Anti-Retroviral Agents

Condition Hierarchy (Ancestors)

HIV InfectionsBlood-Borne InfectionsCommunicable DiseasesInfectionsSexually Transmitted Diseases, ViralSexually Transmitted DiseasesLentivirus InfectionsRetroviridae InfectionsRNA Virus InfectionsVirus DiseasesSlow Virus DiseasesGenital DiseasesUrogenital DiseasesImmunologic Deficiency SyndromesImmune System DiseasesBehavioral SymptomsBehaviorChemically-Induced DisordersMental Disorders

Intervention Hierarchy (Ancestors)

Antiviral AgentsAnti-Infective AgentsTherapeutic UsesPharmacologic ActionsChemical Actions and Uses

Study Officials

  • Christina S Meade, PhD

    Wake Forest University Health Sciences

    PRINCIPAL INVESTIGATOR
  • Adam W Carrico, PhD

    Florida International University

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Christina S Meade, PhD

CONTACT

Sheri L Towe, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: This study will utilize two treatment arms in which participants are randomized using a 2:1 allocation. Arm A will receive the ARTEMIS intervention immediately following their baseline visit. Arm B will be considered a wait-list control, being offered the ARTEMIS intervention after a 6-month delay.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 3, 2025

First Posted

February 7, 2025

Study Start

April 29, 2025

Primary Completion (Estimated)

May 31, 2028

Study Completion (Estimated)

December 31, 2028

Last Updated

September 11, 2025

Record last verified: 2025-09

Data Sharing

IPD Sharing
Will share

All individual-level phenotypic, clinical, genomic, and neuroimaging data for all research subjects will be preserved and deposited in designated NIH-supported repositories for sharing broadly with the scientific community (described below). While identifiers will be collected, all data will be de-identified prior to deposit into any repository. Shared data will include raw and processed files for genomic and neuroimaging data. Recruitment progress and final results will be documented at ClinicalTrials.gov. The sources of data include clinical interviewing, computerized questionnaires, neuropsychological testing, biological sampling (blood and urine), MRI neuroimaging, and medical record review. The final dataset from this project will also include data on demographic factors (including biological variables) and clinical variables such as HIV disease characteristics.

Shared Documents
STUDY PROTOCOL, ICF
Time Frame
The investigators will lock the data until the primary analyses are completed and accepted for publication, after which the investigators will make the data as widely available as possible. Data and supporting documentation will be prepared for deposit in the appropriate repositories in Years 4-5 of the project, with deposit occurring in the final quarter of Year 5 (Q4 2029).
Access Criteria
All data for all research subjects will be preserved and deposited in designated NIH-supported repositories for sharing broadly with the scientific community. Anyone with access to these repositories will have access to the deidentified data from this project.

Locations