Reback Cathy J, Lin Chunqing, Li Michael J, Fletcher Jesse B, Mata Raymond P
Friends Research Institute, Inc., Los Angeles, CA, USA.
Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
AIDS Behav. 2025 Jul 18. doi: 10.1007/s10461-025-04816-6.
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.
性少数群体男性（SMM）使用甲基苯丙胺的比例较高，这种药物深深融入了他们的性身份、性行为和文化空间。智能手机应用程序（应用）常被用于获取毒品和性伴侣。本研究是一项随机临床试验，评估了将基于证据的干预措施（《戒毒》）改编为移动应用程序格式后的效果。2021年5月至2023年5月，226名在过去一年中自我报告使用过甲基苯丙胺的性少数群体男性被随机分为立即交付（ID）《戒毒》应用程序组（n = 113）或延迟三十天交付（DD）《戒毒》应用程序组（n = 113）。甲基苯丙胺使用障碍（MUD）的平均DSM-5评分处于严重范围（满分11分，平均为8.9分）。混合效应模型显示，在1个月的评估中，与延迟交付组相比，立即交付组的参与者在过去30天内使用甲基苯丙胺注射的天数显著减少（估计值 = -0.57；标准误 = 0.15；p < 0.001），发生无保护肛交（CAI）的可能性较低（估计值 = -1.14；标准误 = 0.47；p = 0.017），以及在甲基苯丙胺作用下发生无保护肛交的可能性较低（估计值 = -1.15；标准误 = 0.49；p = 0.021）。在比较应用程序交付前后时，立即交付组和延迟交付组合并样本在所有甲基苯丙胺使用和性风险结果方面均有显著降低，包括使用和注射甲基苯丙胺的天数、无保护肛交以及在甲基苯丙胺作用下进行无保护肛交（所有应用程序交付后的评估p < 0.05，在某些时间点有一些波动）。总体而言，甲基苯丙胺使用和性风险行为的减少证明了《戒毒》应用程序的有效性，这对于基于应用程序的治疗选择的未来极具前景。
