231 The CoMBo Study: Combined Contingency Management for Both Stimulant Use and HIV
OBJECTIVES/GOALS: Contingency management (CM), wherein patients earn prizes for behavior change, is the gold-standard for reducing stimulant misuseand has been shown to improve medication adherence.We aim to describe the feasibility, acceptability, and effectiveness of CM to reduce stimulant use and...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2024-04-01
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| Series: | Journal of Clinical and Translational Science |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2059866124002139/type/journal_article |
| _version_ | 1797226898216976384 |
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| author | Gabriela Steiner Elise Riley Gabriel Chamie Stefan Baral Kelly Knight Phillip Coffin Monica Gandhi Ayesha Appa |
| author_facet | Gabriela Steiner Elise Riley Gabriel Chamie Stefan Baral Kelly Knight Phillip Coffin Monica Gandhi Ayesha Appa |
| author_sort | Gabriela Steiner |
| collection | DOAJ |
| description | OBJECTIVES/GOALS: Contingency management (CM), wherein patients earn prizes for behavior change, is the gold-standard for reducing stimulant misuseand has been shown to improve medication adherence.We aim to describe the feasibility, acceptability, and effectiveness of CM to reduce stimulant use and optimize ART adherence in Women’s HIV primary care. METHODS/STUDY POPULATION: Using the ADAPT-ITT model for adapting evidence-based HIV interventions, we implemented the CoMBostudy at the Ward 86 Women’s Clinic at San Francisco General Hospital. Inclusion criteria are (1) adult age women with HIV, (2) suboptimal ART adherence, (3) stimulant use disorder with goal of reduced-use. Participants receive weekly CM for 12 weeks with escalating incentives for point-of-care urine testing negative for stimulants and positive for tenofovir ART. We use mixed methods to evaluate feasibility and acceptability ofCoMBowith quantitative process measures, sequential explanatory in-depth interviews with participants and staff, and effectiveness by proportion of point-of-care urine tests without stimulants and with tenofovir. RESULTS/ANTICIPATED RESULTS: CoMBoStudy enrollment began in September 2023; n=10 participants have enrolled with an additional n=20 planned.We will report feasibility and acceptability using:1) the number of women with HIV, stimulant use disorder, and suboptimal ART adherence enrolled vs. recruited, 2) the number and proportion of CM sessions attended/missed, 3) cost per participant, and 4) participant-reported facilitators and barriers to CM engagement. We will report preliminary effectiveness based on: 1) proportion of POC tests negative for stimulants, positive for ART, and 2)trend in self-reported stimulant use assessed weekly during CM. DISCUSSION/SIGNIFICANCE: Women with comorbid HIV and stimulant use disorder have demonstrated poor outcomes including reduced ART adherence and faster progression to AIDS. This work aims to expand access to evidence-based treatment for stimulant use disorder for women with HIV and share key opportunities and challenges for doing so in the women’s health HIV primary setting. |
| first_indexed | 2024-04-24T14:32:13Z |
| format | Article |
| id | doaj.art-9208c13e1fd841738bc0e79a43c4cd3e |
| institution | Directory Open Access Journal |
| issn | 2059-8661 |
| language | English |
| last_indexed | 2024-04-24T14:32:13Z |
| publishDate | 2024-04-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Journal of Clinical and Translational Science |
| spelling | doaj.art-9208c13e1fd841738bc0e79a43c4cd3e2024-04-03T02:00:21ZengCambridge University PressJournal of Clinical and Translational Science2059-86612024-04-018696910.1017/cts.2024.213231 The CoMBo Study: Combined Contingency Management for Both Stimulant Use and HIVGabriela Steiner0Elise Riley1Gabriel Chamie2Stefan Baral3Kelly Knight4Phillip Coffin5Monica Gandhi6Ayesha Appa7University of California, San FranciscoUniversity of California, San FranciscoUniversity of California, San FranciscoJohns Hopkins UniversityUniversity of California, San FranciscoUniversity of California, San FranciscoUniversity of California, San FranciscoUniversity of California, San FranciscoOBJECTIVES/GOALS: Contingency management (CM), wherein patients earn prizes for behavior change, is the gold-standard for reducing stimulant misuseand has been shown to improve medication adherence.We aim to describe the feasibility, acceptability, and effectiveness of CM to reduce stimulant use and optimize ART adherence in Women’s HIV primary care. METHODS/STUDY POPULATION: Using the ADAPT-ITT model for adapting evidence-based HIV interventions, we implemented the CoMBostudy at the Ward 86 Women’s Clinic at San Francisco General Hospital. Inclusion criteria are (1) adult age women with HIV, (2) suboptimal ART adherence, (3) stimulant use disorder with goal of reduced-use. Participants receive weekly CM for 12 weeks with escalating incentives for point-of-care urine testing negative for stimulants and positive for tenofovir ART. We use mixed methods to evaluate feasibility and acceptability ofCoMBowith quantitative process measures, sequential explanatory in-depth interviews with participants and staff, and effectiveness by proportion of point-of-care urine tests without stimulants and with tenofovir. RESULTS/ANTICIPATED RESULTS: CoMBoStudy enrollment began in September 2023; n=10 participants have enrolled with an additional n=20 planned.We will report feasibility and acceptability using:1) the number of women with HIV, stimulant use disorder, and suboptimal ART adherence enrolled vs. recruited, 2) the number and proportion of CM sessions attended/missed, 3) cost per participant, and 4) participant-reported facilitators and barriers to CM engagement. We will report preliminary effectiveness based on: 1) proportion of POC tests negative for stimulants, positive for ART, and 2)trend in self-reported stimulant use assessed weekly during CM. DISCUSSION/SIGNIFICANCE: Women with comorbid HIV and stimulant use disorder have demonstrated poor outcomes including reduced ART adherence and faster progression to AIDS. This work aims to expand access to evidence-based treatment for stimulant use disorder for women with HIV and share key opportunities and challenges for doing so in the women’s health HIV primary setting.https://www.cambridge.org/core/product/identifier/S2059866124002139/type/journal_article |
| spellingShingle | Gabriela Steiner Elise Riley Gabriel Chamie Stefan Baral Kelly Knight Phillip Coffin Monica Gandhi Ayesha Appa 231 The CoMBo Study: Combined Contingency Management for Both Stimulant Use and HIV Journal of Clinical and Translational Science |
| title | 231 The CoMBo Study: Combined Contingency Management for Both Stimulant Use and HIV |
| title_full | 231 The CoMBo Study: Combined Contingency Management for Both Stimulant Use and HIV |
| title_fullStr | 231 The CoMBo Study: Combined Contingency Management for Both Stimulant Use and HIV |
| title_full_unstemmed | 231 The CoMBo Study: Combined Contingency Management for Both Stimulant Use and HIV |
| title_short | 231 The CoMBo Study: Combined Contingency Management for Both Stimulant Use and HIV |
| title_sort | 231 the combo study combined contingency management for both stimulant use and hiv |
| url | https://www.cambridge.org/core/product/identifier/S2059866124002139/type/journal_article |
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