Pilot trial of an expressive writing intervention with HIV-positive methamphetamine-using men who have sex with men

Psychol Addict Behav. 2015 Jun;29(2):277-82. doi: 10.1037/adb0000031. Epub 2014 Dec 1.

Abstract

Among men who have sex with men (MSM), the co-occurrence of trauma and stimulant use has negative implications for HIV/AIDS prevention. HIV-positive, methamphetamine-using MSM were recruited to pilot test a 7-session, multicomponent resilient affective processing (RAP) intervention that included expressive writing exercises targeting HIV-related traumatic stress. An open-phase pilot with 10 participants provided support for feasibility of intervention delivery such that 99% of the RAP sessions were completed in a 1-month period. Subsequently, 23 additional participants were enrolled in a pilot randomized controlled trial of the RAP intervention (n = 12) versus an attention-control condition that included writing exercises about neutral topics (n = 11). Acceptability was evidenced by participants randomized to RAP expressing significantly more negative emotions in their writing and reporting greater likelihood of recommending expressive writing exercises to a friend living with HIV. Over the 3-month follow-up period, attention-control participants reported significant decreases in HIV-related traumatic stress while RAP intervention participants reported no significant changes. Compared to attention-control participants, those in the RAP intervention reported significant reductions in the frequency of methamphetamine use immediately following the 1-month RAP intervention period. Thematic analyses of RAP expressive writing exercises revealed that multiple negative life events characterized by social stigma or loss contribute to the complex nature of HIV-related traumatic stress. Findings support the feasibility and acceptability of an exposure-based intervention targeting HIV-related traumatic stress. However, more intensive intervention approaches that simultaneously target trauma and stimulant use will likely be needed to optimize HIV/AIDS prevention efforts with this population. (PsycINFO Database Record

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Attention
  • Central Nervous System Stimulants*
  • HIV Infections / complications
  • HIV Infections / psychology*
  • Homosexuality, Male / psychology*
  • Humans
  • Male
  • Methamphetamine*
  • Middle Aged
  • Pilot Projects
  • Psychotherapy / methods*
  • Resilience, Psychological
  • Self-Control
  • Stress Disorders, Traumatic / etiology
  • Stress Disorders, Traumatic / therapy*
  • Treatment Outcome
  • Writing*

Substances

  • Central Nervous System Stimulants
  • Methamphetamine