{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T06:47:40Z","timestamp":1778741260316,"version":"3.51.4"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K12AR084219"],"award-info":[{"award-number":["K12AR084219"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["DP2DA060600"],"award-info":[{"award-number":["DP2DA060600"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["2K24DA042720"],"award-info":[{"award-number":["2K24DA042720"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01NR020437"],"award-info":[{"award-number":["R01NR020437"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stimulants, 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 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 &amp;lt; .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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Contingency 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.<\/jats:p>\n                    <jats:p>Clinical Trials Registration. \u00a0clinicaltrials.gov (NCT06564792).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag006","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T12:43:38Z","timestamp":1767789818000},"page":"e728-e734","source":"Crossref","is-referenced-by-count":1,"title":["Integrating HIV and Stimulant-Use Disorder Treatment: A Pilot Implementation Effectiveness Trial of Contingency Management in HIV Care"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4602-5954","authenticated-orcid":false,"given":"Ayesha","family":"Appa","sequence":"first","affiliation":[{"name":"Department of Medicine, University of California , San Francisco, California 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