Group-based randomized trial of contingencies for health and abstinence in HIV patients.
- 1 February 2010
- journal article
- research article
- Published by American Psychological Association (APA) in Journal of Consulting and Clinical Psychology
- Vol. 78 (1), 89-97
- https://doi.org/10.1037/a0016778
Abstract
Contingency management (CM) treatments are usually applied individually for drug abstinence, but CM can also be targeted toward health behaviors and implemented in groups. This study evaluated effects of a group-based CM intervention that focused on reinforcing health behaviors. HIV-positive patients with cocaine or opioid use disorders (n = 170) were randomized to weekly CM or 12-step (TS) groups for 24 weeks (mean attendance was 10.8 +/- 8.1 sessions for CM participants and 9.0 +/- 6.9 session for TS participants). During the treatment period, both groups received compensation for attendance ($10 per session) and submission of urine samples (about $2 per sample). In addition, participants received $25 for submitting samples and completing evaluations at Months 1, 3, 6, 9, and 12; 65-75 of the 81 participants assigned to TS and 71-80 of the 89 participants assigned to CM completed these evaluations. During the treatment period, patients in the CM group received chances to win prizes contingent upon completing health activities and submitting substance-free specimens (M = $260, SD = $267). Mean attendance was 10.8 +/- 8.1 sessions for CM participants and 9.0 +/- 6.9 sessions for TS participants. CM participants submitted a significantly greater number of consecutive drug-free specimens than did TS participants (5.2 +/- 6.0 vs. 3.7 +/- 5.6), but proportions of negative samples did not differ between groups during treatment or at follow-up evaluations. From pre- to posttreatment, CM participants showed greater reductions in viral loads and HIV-risk behaviors than did TS participants, but these effects were not maintained throughout the follow-up period. These data suggest the efficacy of group-based CM for HIV-positive substance abusers, but more research is needed to extend the long-term benefits.Keywords
Funding Information
- National Institutes of Health (R01- DA14618 ; M01-RR06192 ; R01-DA13444 ; R01-DA018883 ; R01-DA016855 ; R01-DA021567 ; R01-DA022739 ; RO1- DA024667 ; P60-AA03510 ; P50-DA09241 ; T32-AA07290)
This publication has 47 references indexed in Scilit:
- Contingency management reduces drug‐related human immunodeficiency virus risk behaviors in cocaine‐abusing methadone patientsAddiction, 2008
- Voucher reinforcement improves medication adherence in HIV-positive methadone patients: A randomized trialDrug and Alcohol Dependence, 2007
- Contingency management for treatment of substance use disorders: a meta‐analysisAddiction, 2006
- HIV treatment in drug abusers: impact of alcohol useAddiction Biology, 2003
- Predictive validity of the Addiction Severity Index's composite scores in the assessment of 2-year outcomes in a methadone maintenance population.Psychology of Addictive Behaviors, 2001
- Initial abstinence and success in achieving longer term cocaine abstinence.Experimental and Clinical Psychopharmacology, 2000
- Contingent reinforcement increases cocaine abstinence during outpatient treatment and 1 year of follow-up.Journal of Consulting and Clinical Psychology, 2000
- Reinforcing operants other than abstinence in drug abuse treatment: An effective alternative for reducing drug use.Journal of Consulting and Clinical Psychology, 1997
- The reliability and validity of a scale to measure HIV risk-taking behaviour among intravenous drug usersAIDS, 1991
- Illness concerns, attitudes towards homosexuality, and social support in gay men with AIDSGeneral Hospital Psychiatry, 1986