Unintended positive substance abuse outcomes from an HIV sexual risk reduction intervention for methamphetamine using MSM

BACKGROUND: A six-session, individual-level behavioral intervention called ARM-U was designed to decrease HIV-associated sexual practices among methamphetamine using men who have sex with men (MSM). Although unintended in the design, we hypothesized that the intervention might also influence utilization of substance abuse treatment and substance use. METHODS: A total of 68 self-identified MSM who reported unprotected anal intercourse with a non-primary partner and methamphetamine use at least once during the prior 2 months were included in a single-arm, pre/post trial of the intervention. Bivariate analyses were conducted to compare participants' self-reported change in utilization of substance abuse treatment and injection drug use during the 2 months before and 2 months after the intervention. RESULTS: Of 80 participants enrolled, 68 (85%) completed the intervention and follow-up assessment. The median age was 41 years (IQR: 35-46). Compared to baseline, there was a statistically significant increase in utilization of substance abuse programs and services (44.6% vs. 50%, p≤0.001) and decrease in injection drug use (51.5% vs. 22.1%, p<0.05) during the 2 months post-intervention. However, participants were less likely to attend Crystal Meth Anonymous meetings after the intervention (44.1% vs. 25%, p≤0.001). CONCLUSIONS: Although the ARM-U intervention was designed to decrease HIV-associated sexual risk, it also appeared to have a beneficial effect on substance use and utilization of substance abuse treatment. Reducing methamphetamine use may be a strategy used to reduce sexual risk. Randomized controlled trials are needed to determine the efficacy of the intervention and mechanisms for changing these behaviors.