A Treatment Mobile App for Sexual Minority Men Who Use Methamphetamine Demonstrates Reductions in Methamphetamine Use and HIV Sexual Risk Behaviors: Getting Off.

Abstract

Sexual minority men (SMM) have elevated rates of methamphetamine use, which is deeply integrated into their sexual identities, sexual behaviors, and cultural spaces. Smartphone applications (apps) are often used to procure drugs and sexual partners. This study was a randomized clinical trial that evaluated the efficacy of the adaptation of an evidence-based intervention (Getting Off) into a mobile app format. From May 2021 to May 2023, 226 SMM who self-reported methamphetamine use in the past year were randomized to immediate delivery (ID) of the Getting Off app (n = 113) or a 30-day delayed delivery (DD) of the Getting Off app (n = 113). The average DSM-5 score for MUD was in the severe range (8.9 out of a possible 11). Mixed-effects models showed that at 1-month assessment, participants in the ID condition had significantly fewer days of injection methamphetamine use (estimate = - 0.57; SE = 0.15; p < 0.001), lower likelihood to have condomless anal intercourse (CAI; estimate = - 1.14; SE = 0.47; p = 0.017), and CAI while high on methamphetamine (estimate = - 1.15; SE = 0.49; p = 0.021) in the past 30 days, compared to the DD condition. When comparing pre- to post-app delivery, the combined ID and DD sample showed significant reductions in all methamphetamine use and sexual risk outcomes, including days using and injecting methamphetamine, CAI, and CAI while high on methamphetamine (p < 0.05 for all post-app assessments, with some fluctuations at certain time points). Overall, the reductions in methamphetamine use and sexual risk behaviors demonstrated the efficacy of the Getting Off app, which is extremely promising for the future of app-based treatment options.