title: Pilot trial of an expressive writing intervention with HIV-positive methamphetamine-using men who have sex with men.
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
authors.affiliation: School of Nursing, University of California, San Francisco.
authors.forename: Adam W
authors.initials: AW
authors.lastname: Carrico
authors.affiliation: School of Nursing, University of California, San Francisco.
authors.forename: Austin
authors.initials: A
authors.lastname: Nation
authors.affiliation: School of Nursing, University of California, San Francisco.
authors.forename: Walter
authors.initials: W
authors.lastname: Gómez
authors.affiliation: Graduate School of Transpersonal Studies, Sofia University.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Sundberg
authors.affiliation: Center for AIDS Prevention Studies, University of California, San Francisco.
authors.forename: Samantha E
authors.initials: SE
authors.lastname: Dilworth
authors.affiliation: Center for AIDS Prevention Studies, University of California, San Francisco.
authors.forename: Mallory O
authors.initials: MO
authors.lastname: Johnson
authors.affiliation: Osher Center for Integrative Medicine, University of California, San Francisco.
authors.forename: Judith T
authors.initials: JT
authors.lastname: Moskowitz
authors.affiliation: School of Nursing, University of California, San Francisco.
authors.forename: Carol Dawson
authors.initials: CD
authors.lastname: Rose
mesh_terms: D000328:Adult; D001288:Attention; D000697:Central Nervous System Stimulants; D015658:HIV Infections / Q000150:complications / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008694:Methamphetamine; D008875:Middle Aged; D010865:Pilot Projects; D011613:Psychotherapy / Q000379:methods*; D055500:Resilience, Psychological; D000068356:Self-Control; D040921:Stress Disorders, Traumatic / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D014956:Writing
chemical_list: D000697:Central Nervous System Stimulants; D008694:Methamphetamine