We successfully implemented a methamphetamine treatment program for methamphetamine-dependent men using CM. Participant characteristics and abstinence outcomes were comparable to MSM who received CM as part of a treatment research program . The 30% retention rate for PROP at the end of 12 weeks is lower than that in studies of CM among methamphetamine-dependent MSM  and methamphetamine-dependent heterosexuals . One reason may be that outcomes using CM are sensitive to the richness of the reinforcement schedule  and participants in PROP could earn approximately one-third possible in the other CM reports. Despite differences in retention, the average earning per participant in PROP (35.1% of the maximum) is close to that reported in treatment research on the use of CM with methamphetamine-dependent MSM (32.4% of the maximum) .
CM was popular among the target community and readily delivered by health department staff with limited training in substance abuse treatment. In San Francisco, methamphetamine-using MSM were willing to comply with the requirement for thrice-weekly observed urine collection in order to reduce their methamphetamine use. Our preliminary findings suggest that the contingency management approach is a feasible and cost-effective means to reduce methamphetamine use in community settings.
The feasibility of PROP is further suggested by the strong participation in the program. One concern is that indigent individuals who do not use methamphetamine may try to "scam" the program in order to access financial benefit. The low rates of complete abstinence in this project do not support that concern. PROP participants report long histories of methamphetamine use with current use indicated by a positive urine drug screen at admission or medical documentation. Further, PROP participants responded to the CM at similar rates in producing metabolite-free urine samples as did treatment-seeking methamphetamine-dependent MSM . If methamphetamine-naïve PROP participants did try to deceptively enter into the program, results indicate they were unable to do it consistently.
The costs of implementing PROP were reasonable. In this community-based program, fixed costs included the contingencies ($17,649), a one-time rent payment ($25,000) and urine test kit costs ($6,700). Staffing required one full-time study coordinator and a part-time assistant totaling $65,000 yearly. The total allocated for this program was $114,349 or a per-capita cost of $800 for the 143 participants who enrolled in PROP. Costs incurred by public health agencies implementing CM for addressing methamphetamine use among MSM could be lessened by contributions from communities and alternative funding agencies.
This report evaluates PROP as a real-world public health program and not a research project, an approach that precluded linking personally identifying information with responses to the intervention, yielding only group-level responses. These are initial outcomes, as only during-treatment data were available, which limits any understanding of the sustained effects of the CM treatment.