Lower-Cost Contingency Management in a Group Setting - 1

Lower-Cost Contingency Management in a Group Setting

The purpose of this study is to evaluate the efficacy of prize contingency management (CM) in enhancing attendance, reducing drug use, and improving health among clients attending two HIV drop-in centers. Specifically, 172 clients are randomly assigned to one of two 6-month treatment conditions: standard 12-step oriented group treatment, or CM group treatment. In the CM group, clients earn the chance to win prizes for submitting clean urine specimens and for complying with steps toward their treatment goals. Activities related to improving health will be emphasized, such as attending medical appointments, recording daily medication consumption, getting prescriptions filled, and attending medication adherence support groups. Group attendance, drug use, medical problems, services received, and risky drug use and sexual behaviors will be measured pre-treatment and at months 1, 3, 6, 9 and 12.

Inclusion criteria:

• HIV-positive and a member of The Living Center or the Manchester Area Network on AIDS
• DSM-IV diagnosis of current opioid or cocaine abuse or dependence
• willingness to accept random assignment to one of the two treatment groups

Exclusion criteria:

• inability to comprehend the study (Mini-mental status score <21; Folstein & Folstein, 1975; or inability to pass an informed consent quiz)
• severely disruptive behavior
• in recovery for pathological gambling (due to potential similarity between the CM procedure and gambling)
• non-English speaking