Amsterdam 2015
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| Abstract #2309 - Drugs and HIV | ||||
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Session: 34.5: Drugs and HIV (Symposium) on Thursday @ 14.30-16.00 in C103 Chaired by Marianne van der Sande, Don Desjarlais Authors: Presenting Author: Miss Kimberly Rush - UCSF, United States |
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| Additional Authors: | ||||
| Aim: Cognitive-behavioral substance abuse treatment decreases stimulant use and sexual risk behavior in methamphetamine-using men who have sex with men (MSM). Informed by Revised Stress and Coping Theory, this study examined whether positive affect and theory-based processes of recovery predict better substance abuse treatment outcomes in this population. We hypothesized that the association of positive affect with better treatment outcomes would be mediated by enhanced processes of recovery. We also examined whether positive affect moderated the rious associations of negative affect with poorer treatment outcomes. | ||||
| Method / Issue: In total, 88 methamphetamine-using MSM seeking cognitive-behavioral substance abuse treatment in San Francisco were enrolled in a 6-month treatment outcome study. Baseline positive (Cronbach’s alpha = 0.91) and negative (Cronbach’s alpha = 0.87) affect were measured by the modified Differential Emotions Scale. Time-varying processes of recovery included: self-efficacy for managing methamphetamine triggers measured by the Drug Taking Confidence Questionnaire (Cronbach’s alpha = 0.97) and perceived social support for reducing methamphetamine use measured by an adapted Processes of Change measure (Cronbach’s alpha = 0.86). Outcomes included: number of self-reported days of methamphetamine use in last 30 days and number of anal sex partners while high on methamphetamine in last 3 months. We used generalized estimating equations (GEE) to examine correlates of significant reductions in the previously stated outcomes among 6-month follow-up. | ||||
| Results / Comments: The majority of participants were gay (97%), Caucasian (67%), and HIV-positive (66%) with an average age of 43 (SD = 9) years. In a multivariate model controlling for age, race/ethnicity and HIV-status, greater self-efficacy for managing methamphetamine triggers (adjusted incidence rate ratio [aIRR]=0.97, 95% CI = 0.96-0.97) and perceived social support for reducing methamphetamine use (aIRR=0.92, 95% CI = 0.89-0.95) were independently associated with decreased self-reported methamphetamine use. More perceived social support for reducing methamphetamine use was also independently associated with decreased number of anal sex partners while high on methamphetamine (aIRR=0.92, 95% CI = 0.96-0.99). There was no evidence that higher processes of recovery assessment scores mediated the associations of positive affect with better treatment outcomes. However, positive affect did significantly moderate the association of negative affect with number of anal sex partners while high on methamphetamine (Unstandardized Beta=-0.07, p<.01). At higher levels of positive affect, greater negative affect was associated with a decreased number anal sex partners while high on methamphetamine (Unstandardized Betas=-1.00 – -0.61, p<.05). On the other hand, greater negative affect was associated with an increased number of anal sex partners while high on methamphetamine at lower levels of positive affect (Unstandardized Betas=0.36 – 1.58, p<.05). | ||||
| Discussion: Consistent with Revised Stress and Coping Theory, positive affect buffers against the rious association of negative affect with greater number of anal sex partners while high on methamphetamine. Results also suggest that enhanced self-efficacy for managing methamphetamine triggers and perceived social support to reduce methamphetamine use are independently associated with better substance abuse treatment outcomes. Interventions targeting positive affect and theory-based processes of recovery could boost the effectiveness of substance abuse treatment with methamphetamine-using MSM. | ||||
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