What is the County of Los
Angeles doing?
Prevention for MSM
OAPP is particularly concerned with the evidence that links methamphetamine use among gay men with increased rates of new HIV infection. Within
men who have sex with men (MSM), stimulant abuse, particularly abuse of methamphetamine, continues to be a major factor in driving new infections, as users engage in extremely high-risk sexual transmission behaviors. To
address this, an evidence-based biomedical and behavioral prevention intervention for use in groups of MSM who use methamphetamine and engage in high-risk sexual transmission behaviors
was implemented. This includes the biomedical intervention of Post-exposure Prophylaxis (PEP) for HIV prevention and the behavioral intervention of contingency management
(CM), which targets reduction of methamphetamine use as a way of reducing concomitant high-risk sexual behaviors among HIV-negative methamphetamine-using gay, bisexual, and other MSM.
Post-exposure Prophylaxsis (PEP): PEP involves providing a 28-day regimen of highly active anti-retroviral therapy (similar to the regimens used to treat HIV disease) and HIV risk-reduction education to high-risk individuals after a potential HIV exposure in order to abort HIV seroconversion after that exposure. The safety and feasibility of PEP after sexual exposure has been demonstrated in numerous trials and programs, and is recommended by the federal Department of Health and Human Services, as well as the California Office of AIDS.
Contingency Management (CM): Participants will be
provided with an 8-week course of contingency management
for methamphetamine use concurrent with PEP. This
approach with methamphetamine using MSM has been
demonstrated in controlled treatment trials and in
uncontrolled community demonstrations to aid
participants in significantly reducing methamphetamine
use and concomitant HIV-risk behaviors.
