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Peer-reviewedCC BY 4.0AIDS and Behavior

Multi-method Analysis of Implementation Determinants and Strategies to Support the Implementation of Contingency Management for Methamphetamine Use in an HIV Care Setting

  • Maximo R. Prescott1,2
  • Victoria Chentsova1,2
  • Jorge Delgado1
  • Devin Dung1
  • Steven Shoptaw3
  • Gregory A. Aarons4
  • David J. Moore1,4
  • David Grelotti4
  • Jessica Montoya1,4
4 affiliations
  1. 1HIV Neurobehavioral Research Program, University of California San Diego, 220 Dickinson St # B, San Diego, CA 92103 USA
  2. 2San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA USA
  3. 3Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA USA
  4. 4Department of Psychiatry, University of California San Diego, La Jolla, San Diego, CA USA
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Abstract

Methamphetamine use is prevalent among people with HIV (PWH) and complicates HIV care. Integrated substance use and HIV care services are recommended, yet rarely available. Contingency management (CM) is an evidence-based treatment for methamphetamine use, but its implementation within HIV primary care is limited. This study identified determinants and strategies to support CM implementation in HIV care. Key informants from an HIV clinic at an academic medical center (n = 15 patients; n = 15 providers) completed semi-structured interviews and a survey. A rapid qualitative analysis guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework identified implementation determinants, and potential strategies were classified using the Expert Recommendations for Implementing Change (ERIC) compilation. Both patient and provider participants rated CM as acceptable (M = 3.72 and 4.55/5) and appropriate (M = 3.85 and 4.54/5). Providers also rated CM as feasible (M = 4.08/5) and reported strong support for integrating CM into HIV care, citing the high priority of addressing methamphetamine use. Facilitators included the clinic’s person-centered culture and providers’ familiarity with substance use treatment. Barriers included perceptions that reinforcer values in standard CM protocols were low, limited staffing, and competing provider demands. Suggested implementation strategies included adapting CM (e.g., increasing reinforcer value), patient-directed outreach/advertisements, and provider education and support (e.g., reminders about CM availability and referral processes). Findings indicate strong support for integrating CM into HIV primary care, while noting challenges to implementation. Addressing these determinants through targeted multi-level implementation strategies may enhance CM adoption and sustainment in HIV care settings.

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Cite

BibTeXRIS
BibTeX
@article{prescott2026multimethod,
  title = {{Multi-method Analysis of Implementation Determinants and Strategies to Support the Implementation of Contingency Management for Methamphetamine Use in an HIV Care Setting}},
  author = {Maximo R. Prescott and Victoria Chentsova and Jorge Delgado and Devin Dung and Steven Shoptaw and Gregory A. Aarons and David J. Moore and David Grelotti and Jessica Montoya},
  journal = {AIDS and Behavior},
  year = {2026},
  month = may,
  doi = {10.1007/s10461-026-05115-4},
  url = {https://doi.org/10.1007/s10461-026-05115-4},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Multi-method Analysis of Implementation Determinants and Strategies to Support the Implementation of Contingency Management for Methamphetamine Use in an HIV Care Setting
AU  - Maximo R. Prescott
AU  - Victoria Chentsova
AU  - Jorge Delgado
AU  - Devin Dung
AU  - Steven Shoptaw
AU  - Gregory A. Aarons
AU  - David J. Moore
AU  - David Grelotti
AU  - Jessica Montoya
PY  - 2026
DA  - 2026/05/13
JO  - AIDS and Behavior
DO  - 10.1007/s10461-026-05115-4
UR  - https://doi.org/10.1007/s10461-026-05115-4
AB  - Methamphetamine use is prevalent among people with HIV (PWH) and complicates HIV care. Integrated substance use and HIV care services are recommended, yet rarely available. Contingency management (CM) is an evidence-based treatment for methamphetamine use, but its implementation within HIV primary care is limited. This study identified determinants and strategies to support CM implementation in HIV care. Key informants from an HIV clinic at an academic medical center (n = 15 patients; n = 15 providers) completed semi-structured interviews and a survey. A rapid qualitative analysis guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework identified implementation determinants, and potential strategies were classified using the Expert Recommendations for Implementing Change (ERIC) compilation. Both patient and provider participants rated CM as acceptable (M = 3.72 and 4.55/5) and appropriate (M = 3.85 and 4.54/5). Providers also rated CM as feasible (M = 4.08/5) and reported strong support for integrating CM into HIV care, citing the high priority of addressing methamphetamine use. Facilitators included the clinic’s person-centered culture and providers’ familiarity with substance use treatment. Barriers included perceptions that reinforcer values in standard CM protocols were low, limited staffing, and competing provider demands. Suggested implementation strategies included adapting CM (e.g., increasing reinforcer value), patient-directed outreach/advertisements, and provider education and support (e.g., reminders about CM availability and referral processes). Findings indicate strong support for integrating CM into HIV primary care, while noting challenges to implementation. Addressing these determinants through targeted multi-level implementation strategies may enhance CM adoption and sustainment in HIV care settings.
SN  - 1090-7165
SN  - 1573-3254
ER  -