3 - (SYM 52) Patterns of Mental Health and Stimulant Use Among a Sample of SMM with HIV: Results from a Pilot Clinical Trial of a Psychobehavioral Intervention for People Who Use Drugs

Sexual minority men (SMM) continue to be disproportionately affected by HIV. Among SMM with HIV (SMMH), drivers of poorer HIV health outcomes include untreated psychobehavioral health challenges, such as mental health and substance use disorders. To optimize HIV health outcomes in SMMH with substance use disorder (SUDS), more accessible interventions are needed to address their psychobehavioral needs. The MATTER intervention is a community-informed text-enhanced psychobehavioral intervention designed to mitigate the negative consequences of internalized stigma among SMMH with SUDs. Using pre-post data from 50 SMMH recruited in Boston, MA, for the pilot randomized controlled trial of MATTER, we examined pre-post (baseline vs. 2-month, 6-month follow-up [2mfu, 6mfu]) differences in mental health and stimulant use by treatment condition (n = 25 intervention, n = 25 control). We assessed for stimulant use frequency in the past 3 months. Mental health included symptoms (assessed using the Patient Health Questionnaire-9), major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) diagnoses (assessed using the Mini-International Neuropsychiatric Interview). At baseline, 84% of our sample reported using stimulants in the past 3 months, with more than 80% meeting criteria for MDD and almost 30% for PTSD. Analyses included paired t-tests and one-sample tests of proportion. Results revealed that both conditions exhibited significant reductions in stimulant use at both 2mfu (ps < 0.001) and 6mfu (ps < 0.05), relative to baseline, with mean reductions at 6mfu greater for the intervention condition than control (M = -1.53 vs. -1.01, respectively). We also observed significant reductions in depression severity for the intervention condition at 6mfu relative to baseline (p < 0.05). When examining mental health diagnoses, results indicated significant differences in the proportion of people meeting criteria for MDD in both conditions (zs = -5.12 and -4.16, p</span>s < .05) and for PTSD only in the treatment condition (z = -2.98, p < .001). For MDD, there were greater differences observed in the intervention condition relative to control (43.6% vs. 31.8%). In sum, the results demonstrate that engagement in the study improved mental health and stimulant use in our sample overall, with greater improvements for those who received the MATTER intervention. The study provides promising evidence of the benefits of the MATTER intervention in addressing the psychobehavioral needs of SMMH with SUDS, an underserved community that deserves attention.