Evidence map›Paper›PMID 41505433›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2026

Integrating HIV and Stimulant-Use Disorder Treatment: A Pilot Implementation Effectiveness Trial of Contingency Management in HIV Care.

Ayesha Appa, Gabriela Steiner, Stefan Baral, Elise Riley, Lauren Suchman, Kate Roberts, Kelly Knight, Meghan Murphy, Gabriel Chamie, Steve Shoptaw and 2 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06564792 (CoMBo Study), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06564792 nacompletednot on this map

CoMBo Study: Contingency Management for Both HIV And Stimulant Use in Primary Care

TypeinterventionalSponsorUniversity of California, San FranciscoRan2023 to 2025Enrolled37ConditionsStimulant Use (Diagnosis), HivArmsContingency management
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Ayesha AppaDepartment of Medicine, University of California, San Francisco, California, USA.ORCID 0000-0002-4602-5954
Gabriela SteinerDepartment of Medicine, University of California, San Francisco, California, USA.
Stefan BaralDivision of Infectious Disease Epidemiology and Center for HIV and Stigma Elimination Strategies, Johns Hopkins University, Baltimore, Maryland, USA.
Elise RileyDepartment of Medicine, University of California, San Francisco, California, USA.
Lauren SuchmanDepartment of Social and Behavioral Sciences, University of California, San Francisco, California, USA.ORCID 0000-0002-3684-0314
Kate RobertsBryn Mawr College Graduate School of Social Work and Social Research, Rosemont, Pennsylvania, USA.ORCID 0000-0001-7021-2920
Kelly KnightDepartment of Medicine, University of California, San Francisco, California, USA.
Meghan MurphyDepartment of Medicine, University of California, San Francisco, California, USA.ORCID 0000-0002-6882-7958
Gabriel ChamieDepartment of Medicine, University of California, San Francisco, California, USA.ORCID 0000-0002-5860-8081
Steve ShoptawDepartment of Family Medicine, University of California, Los Angeles, California, USA.
Phillip O CoffinDepartment of Medicine, University of California, San Francisco, California, USA.ORCID 0000-0002-3891-6570
Monica GandhiDepartment of Medicine, University of California, San Francisco, California, USA.ORCID 0000-0002-7025-1994

Funding

Virology CoreP30AI027763 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI STEVEN Grant DEEKS · 1988 to 2026
$93.6M
Characterizing the role of social, behavioral, and economic stigmas as determinants of HIV and mental health across the USR01NR020437 · NINR · JOHNS HOPKINS UNIVERSITY · PI BARAL, STEFAN DAVID · 2021 to 2025
$3.9M
“Hair Lengthening”: Using Hair Levels to Interpret Long-Acting PrEP Studies.R37AI098472 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Monica Gandhi · 2023 to 2026
$3.2M
University of California, San Francisco/Kaiser Permanente Northern California Division of Research Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) K12 ProgramK12AR084219 · NIAMS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Monica Gandhi, CYNTHIA C HARPER · 2023 to 2026
$3.1M
Taking Our Shot: Extended-Release Naltrexone as Opioid Overdose Pre-Exposure Prophylaxis (PrEP) in People Using Stimulants Living With or At Risk of HIVDP2DA060600 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI APPA, AYESHA A · 2024 to 2024
$2.5M
Mentorship in patient-oriented research to optimize community-based HIV prevention for adults at high-risk of HIV at alcohol drinking venues in East AfricaK24AA031211 · NIAAA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Gabriel Chamie · 2023 to 2026
$785k
NIAAA NIH HHS K24 AA031211NIAID NIH HHS P30 AI027763NIAID NIH HHS R37 AI098472NIH HHS 2K24DA042720NIH HHS DP2DA060600NIH HHS K12AR084219NIH HHS R01NR020437
6 · The paper itself

Abstract

backgroundStimulants, including cocaine and methamphetamine, are associated with HIV transmission and viremia. Contingency management (CM), which provides financial incentives for nonreactive urine testing, is first-line treatment for stimulant-use disorder (StUD), yet has been minimally studied or integrated into HIV care.

methodsWe conducted a 12-week, single-arm, implementation-effectiveness pilot of weekly CM in a safety-net HIV clinic for persons with HIV (PWH) who have StUD. Participants received escalating incentives for stimulant-negative and/or tenofovir-reactive point-of-care urine assays. Using the RE-AIM framework, we evaluated Reach (demographics, attendance), Effectiveness (stimulant-negative/tenofovir-positive tests, HIV virologic suppression [VS]), and Implementation. We conducted semi-structured, in-depth participant interviews following intervention completion to explore perceived impact and implementation.

resultsFrom September 2023 to February 2024, we enrolled 31 PWH with StUD: 77% used methamphetamine, 35% cocaine, and 19% fentanyl. Only 17 of 31 (55%) had VS at baseline. Participants attended a mean of 5 of 12 visits (42%). Among PWH who attended postenrollment visits (26/31), 61 of 110 (56%) stimulant tests were negative and 98% (89/91) of tenofovir tests were positive. Postintervention, 88% (23/26) of retained participants achieved VS (P < .01). Qualitative interviews revealed factors enhancing Reach (embedding CM within HIV care), Effectiveness (incentives supporting adherence self-efficacy; program providing structure and motivation), and Implementation (supportive staff relationships, nonjudgmental approach).

conclusionsContingency management for stimulant use and/or antiretroviral therapy adherence (using point-of-care tenofovir assays) embedded into HIV care was associated with reduced stimulant use and gains in viral suppression. Scalability of integrating HIV and StUD management using CM merits further evaluation. Clinical Trials Registration.  clinicaltrials.gov (NCT06564792).

Indexed as

HIV InfectionsSubstance-Related DisordersAdherence InterventionsAdultAnti-HIV AgentsBehavior TherapyCocaineFemaleHumansMaleMethamphetamineMiddle AgedMotivationPilot ProjectsTenofovirAnti-HIV AgentsCocaineMethamphetamineTenofovircontingency managementHIV careimplementation scienceintegrated carestimulant use disorder treatment

Identifiers

PMID41505433
PMCPMC13131947

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.