학술논문

Effect of a brief alcohol counselling intervention on HIV viral suppression and alcohol use among persons with HIV and unhealthy alcohol use in Uganda and Kenya: a randomized controlled trial
Document Type
article
Source
Journal of the International AIDS Society. 26(12)
Subject
Biomedical and Clinical Sciences
Public Health
Health Sciences
Alcoholism
Alcohol Use and Health
Substance Misuse
Clinical Research
Women's Health
Infectious Diseases
Clinical Trials and Supportive Activities
Screening And Brief Intervention For Substance Abuse
Prevention
Sexually Transmitted Infections
HIV/AIDS
Good Health and Well Being
Humans
Male
Female
HIV Infections
Alcoholism
Uganda
Kenya
Counseling
Ethanol
HIV
viral suppression
alcohol use
brief counselling intervention
sub-Saharan Africa
randomized controlled trial
Clinical Sciences
Public Health and Health Services
Other Medical and Health Sciences
Clinical sciences
Epidemiology
Public health
Language
Abstract
IntroductionUnhealthy alcohol use significantly contributes to viral non-suppression among persons with HIV (PWH). It is unknown whether brief behavioural interventions to reduce alcohol use can improve viral suppression among PWH with unhealthy alcohol use in sub-Saharan Africa (SSA).MethodsAs part of the SEARCH study (NCT04810650), we conducted an individually randomized trial in Kenya and Uganda of a brief, skills-based alcohol intervention among PWH with self-reported unhealthy alcohol use (Alcohol Use Disorders Identification Test-Consumption [AUDIT-C], prior 3 months, ≥3/female; ≥4/male) and at risk of viral non-suppression, defined as either recent HIV viral non-suppression (≥400 copies/ml), missed visits, out of care or new diagnosis. The intervention included baseline and 3-month in-person counselling sessions with interim booster phone calls every 3 weeks. The primary outcome was HIV viral suppression (200 ng/ml (RR 0.97, 95% CI: 0.92-1.02).ConclusionsIn a randomized trial of 401 PWH with unhealthy alcohol use and risk for viral non-suppression, a brief alcohol intervention reduced unhealthy alcohol use but did not affect viral suppression at 24 weeks. Brief alcohol interventions have the potential to improve the health of PWH in SSA by reducing alcohol use, a significant driver of HIV-associated co-morbidities.