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Feasibility, Acceptability, and Tolerability of Targeted Naltrexone for Nondependent Methamphetamine-Using and Binge-Drinking Men Who Have Sex with Men

Santos, Glenn-Milo et al.

Journal of acquired immune deficiency syndromes: JAIDS. Volume 72:Number 1 (2016) -- Wolters Kluwer

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  • Title:
    Feasibility, Acceptability, and Tolerability of Targeted Naltrexone for Nondependent Methamphetamine-Using and Binge-Drinking Men Who Have Sex with Men
  • Author: Santos, Glenn-Milo;
    Coffin, Phillip;
    Santos, Deirdre;
    Huffaker, Shannon;
    Matheson, Tim;
    Euren, Jason;
    DeMartini, Anna;
    Rowe, Christopher;
    Hahn, Judith A.;
    Vlahov, David;
    Vittinghoff, Eric;
    Batki, Steven L.
  • Found In: Journal of acquired immune deficiency syndromes: JAIDS. Volume 72:Number 1 (2016)
  • Journal Title: Journal of acquired immune deficiency syndromes: JAIDS
  • Subjects: Acquired Immunodeficiency Syndrome--Periodicals; AIDS (Disease)--Periodicals; AIDS (Disease); Periodicals; methamphetamine--alcohol--HIV--men who have sex with men--HIV prevention--pharmacotherapy; Dewey: 616.9792005
  • Rights: legaldeposit
  • Publication Details: Wolters Kluwer
  • Abstract: Abstract : Background:

    There are no effective pharmacologic strategies for nondependent methamphetamine (meth)-using and binge-drinking men who have sex with men (MSM) at high-risk for HIV. We sought to determine the feasibility of enrolling and retaining this population in a pharmacologic trial; the acceptability of pharmacotherapy study procedures; and the tolerability of targeted naltrexone versus placebo.

    Methods:

    Thirty meth-using and binge-drinking MSM were randomly assigned 1:1 to 50 mg naltrexone or placebo for 8 weeks for targeted administration (ie, during craving or in anticipation of meth or alcohol use). Substance use counseling and behavioral assessments were conducted every 2 weeks. Medication use was measured using WisePill dispensers.

    Results:

    Trial completion was 93%; visit completion rate was 95%. Mean weekly number of medication pills taken was 2.1 and was similar between arms. Participant satisfaction rate was 96%. There were neither serious adverse events nor differences in adverse event rates between arms. In exploratory intention-to-treat analyses, there were no differences in meth use and drinking. Naltrexone participants had greater reductions in serodiscordant receptive anal intercourse [incident rate ratio (IRR) = 0.15; 95% CI = 0.05 to 0.42] and serodiscordant condomless receptive anal intercourse (IRR = 0.11; 95% CI = 0.03 to 0.37), compared with placebo. In subgroup analyses among frequent meth users, naltrexone participants had greater reductions in meth-using days (IRR = 0.78; 95% CI = 0.62 to 0.99). In as-treated analyses, frequent study medication users in the naltrexone arm had greater reductions in binge drinking days (IRR = 0.72; 95% CI = 0.54 to 0.97).

    Conclusions:

    Targeted naltrexone is a feasible, acceptable, and tolerable intervention strategy for nondependent meth-using and binge-drinking MSM. Naltrexone was associated with significant sexual risk reductions; and for some individuals, naltrexone was associated with meth and binge-drinking reductions.


  • Identifier: System Number: LDEAvdc_100053247480.0x000001; Journal ISSN: 1525-4135; 10.1097/QAI.0000000000000922
  • Publication Date: 2016
  • Physical Description: Electronic
  • Shelfmark(s): ELD Digital store

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