Psychological Flexibility, Trauma, and Highrisk sexual behavior among HIVpositive men who have sex w

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Psychological Flexibility, Trauma, and High-risk
sexual behavior among HIV-positive men who have
sex with men who use methamphetamine

• Maggie Chartier, MPH, MS
• Stanford-Santa Clara County Methamphetamine
  Taskforce
• Clinical Psychology Training Program Fellow, UCSF

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Trisha Vinateri, BS, Kathryn Delonga,
BA PGSP-Stanford Consortium Larry McGlynn,
MD Director, Meth-Taskforce Stanford University
Department of Psychiatry and Behavioral
Medicine Cheryl Gore-Felton, PhD, Cheryl
Koopman PhD Stanford University Department of
Psychiatry and Behavioral Medicine Department
of Drug and Alcohol Services of Santa Clara
County Community Partners in San Jose, CA
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Research Purpose

• Problem of Meth among HIV-positive MSM in Santa
  Clara county, CA
• Concerns of the Meth-Taskforce of Santa Clara
  County
• Collaborative development of research purpose
• To better understand issues related to meth use
  in this population, especially those impacting
  treatment interventions
• Inform HIV prevention efforts

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Main Points

• Pilot study to examine the relationship between
• Psychological Flexibility
• Sexual Risk Behavior
• Trauma
• In HIV-Positive, MSM using methamphetamine

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Demographics

• N23
• Ethnicity
• 2 African American
• 5 Hispanic
• 5 Other (self-identified)
• 11 White
• Mean yrs diagnosed with HIV/AIDS 9.9

• Mean age 42
• Sexuality identity
• 15 gay
• 7 bisexual
• 1 straight
• 9 had been diagnosed with AIDS

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Demographics

• 73.9 used Meth with last month
• 78.3 on disability
• 65.1 had some college or more
• 65.2 made less than 20,000/yr
• 100 had experienced trauma
• Only 22 completed THQ

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Measures included

• The Acceptance and Action Questionnaire-II
  (AAQ-II)
• The Posttraumatic Stress Disorder
  Checklist-Civilian (PCL-C)
• Adult Trauma History Questionnaire
• Addition Severity Index-Self Report (ASI)
• The Adult AIDS Clinical Trial Group
  (ATCG)-follow-up questionnaire
• Trauma History Questionnaire (THQ)
• Chronic Disease Self-Efficacy Scale (CDSES)

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Measures not included in correlations

• Internalized Homophobia Scale
• Valued Living Questionnaire
• Medication Adherence subscales of ATCG
• Subscales of the ASI
• Self-confidence Questionnaire-M (SCQ-M)

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Correlations 1
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Psychological Flexibility

• Correlated with
• Greater reported trauma symptoms
• Current meth use (within last 30 days)
• Poor self-efficacy in chronic illness management
• Reporting higher levels of symptom severity

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Trauma

• Correlated with
• Psychological Flexibility
• Poor self-efficacy in chronic illness management
• Symptom severity
• Years since having HIV
• Not correlated with reported traumatic events on
  THQ (either occurrence or frequency)

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Correlations 2 3

plt 0.01 (2-tailed) plt 0.05 (2-tailed)
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(No Transcript)
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Trauma

• Trauma before 18
• Current trauma symptom report
• ASI psych composite
• Partners with unknown HIV status
• Current reported trauma symptoms
• ASI psych
• Total Sex partners
• Partners with unknown HIV status
• Partners who knew participants HIV status
• Total trauma experienced
• Disability

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Implication of findings

• Trauma history and current symptom report are
  important to consider in clinical work with HIV,
  MSM who use meth
• Psychological Flexibility may be an important
  construct to consider for clients/patients
  engaging in high risk sexual behavior, meth use
  and who have a history of trauma.
• It is important to consider that having HIV for a
  prolonged period of time may be the source of
  trauma-related symptoms.

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Thank you!
maggie_chartier_at_ucsf.edu