Theory-Based Text-Messaging to Reduce Methamphetamine Use and HIV Sexual Risk Behaviors Among Men Who Have Sex with Men: Automated Unidirectional Delivery Outperforms Bidirectional Peer Interactive Delivery


Project Tech Support2 was a randomized controlled trial that tested three methods of text message delivery for reducing methamphetamine use and HIV risks among MSM. From March 2014 to January 2016, 286 methamphetamine-using MSM were randomized into: (1) interactive text conversations with Peer Health Educators, plus five-times-a-day automated theory-based messages, plus a weekly self-monitoring text-message assessment (TXT-PHE; n = 94); or, (2) the daily automated messages and weekly self-monitoring assessment (TXT-Auto; n = 99); or, (3) weekly self-monitoring assessment only (AO; n = 93). All three conditions demonstrated reductions in methamphetamine use (coef. = − 0.10), sex on methamphetamine (coef. = − 0.09), and condomless anal intercourse (CAI) with casual male partners (coef. = − 0.06). Only participants in TXT-PHE and TEXT-Auto also reduced CAI with main male partners (coefTXT-PHE = − 0.19; coef.TXT-Auto = − 0.16), and only TEXT-Auto participants reduced CAI with anonymous male partners (coef. = − 0.05). Additionally, both theory-based text-messaging interventions achieved sustained reductions in five of the six outcomes through 9 months. Overall, automated delivery outperformed peer-delivered messaging.

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Funding for this study was provided by the National Institute on Drug Abuse, Grant #R01DA035092. Drs. Reback and Swendeman acknowledge additional support from the National Institute of Mental Health (P30MH58107). The authors would like to thank Raymond P. Mata for his outstanding work as senior research assistant during the implementation of the study.

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Correspondence to Cathy J. Reback.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Reback, C.J., Fletcher, J.B., Swendeman, D.A. et al. Theory-Based Text-Messaging to Reduce Methamphetamine Use and HIV Sexual Risk Behaviors Among Men Who Have Sex with Men: Automated Unidirectional Delivery Outperforms Bidirectional Peer Interactive Delivery. AIDS Behav 23, 37–47 (2019).

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  • Men who have sex with men (MSM)
  • Methamphetamine
  • HIV
  • mHealth
  • Text messaging (SMS)