Optimizing outpatient treatment outcomes among methamphetamine-using gay and bisexual men through a computerized depression intervention

Abstract

Introduction: Depression is a common sequelae of frequent methamphetamine use, and may influence rates of engagement in sexual risk-taking among methamphetamine-using cisgender gay, bisexual, and other men who have sex with men (GBMSM). The study team hypothesized that layering a brief, computerized depression intervention (i.e., MoodGym; based on Cognitive Behavioral Therapy [CBT] and Interpersonal Therapy) on top of a long-running outpatient methamphetamine treatment program (based on CBT and Contingency Management) for GBMSM could optimize reductions in methamphetamine use and sexual risk-taking among program participants. Methods: This pilot study, which also included analysis of historical data, employed nearest-neighbor matching algorithms to match current pilot study participants (N = 39) to prior participants of an outpatient methamphetamine treatment program (N = 703) and employed treatment effects analyses to determine the observed effects of adding depression intervention content to GBMSM-specific methamphetamine treatment. Results: Pilot study participants who received the MoodGym intervention were significantly less likely to submit methamphetamine-metabolite positive urine samples (Adjusted Treatment Effect [ATE] = −0.72; p < 0.01), and evidenced significantly greater reductions in receptive condomless anal intercourse with non–primary partners in the past 30 days (ATE = −1.39; p < 0.05), relative to prior participants of the outpatient methamphetamine treatment program who did not receive depression intervention content. Conclusion: Preliminary results suggest layering a brief computerized depression intervention onto outpatient methamphetamine treatment for GBMSM may optimize reductions in methamphetamine use and/or sexual risk-taking.