Intervention for alcohol use disorders at an HIV care clinic in Harare : a pilot and feasibility study
Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
BMC (part of Springer Nature)
Abstract
Background: Alcohol use in HIV infected patients is associated with risky sexual behaviour, poor adherence to
Highly Active Antiretroviral Therapy, treatment failure and increased physiologic harm. The objectives of the study
were to pilot the outcome assessments to be used in the trial proper, assess the feasibility of delivery of a brief MI/CBT
intervention compared to an WHO mhGAP intervention for problematic alcohol use in PLWH in Zimbabwe, and pilot
the effectiveness (on alcohol use, functionality and CD4 count) of these interventions at 3 months in a randomised
controlled trial design.
Methods: An intervention for HIV infected patients with problematic alcohol use, developed through adaptation of
existing evidence based psychological treatments, was assessed for its feasibility at a tertiary HIV care clinic in Zimbabwe.
Registered general nurses, using a manualised protocol, delivered the intervention. Forty patients were recruited
and randomised to receive either an MI/CBT intervention or the WHO mhGAP Intervention Guide for AUDs (n = 20
patients per group).
Results: Out of 40 participants enrolled, 31 were successfully followed up for 3 months with a loss to follow-up rate
of 23%. There was a statistically significant decrease in AUDIT score over time in both groups (p < 0.001), however no
statistically significant group difference with a mean difference of 0.80, standard error of 2.07 and p = 0.70. For the
CD4 count, the median and interquartile ranges at baseline for MI/CBT and WHO mhGAP IG groups were 218 (274)
and 484 (211.50), respectively. At follow-up, median and interquartile ranges for the CD4 count for MI/CBT and WHO
mhGAP IG groups were 390 (280) and 567 (378), respectively, indicative of improvement in immunological parameters
in both arms.
Conclusion: The findings from this pilot study suggests that a brief MI/CBT delivered by Registered General Nurses
for problematic alcohol use is feasible in this population but will require the implementation of additional measures
to improve retention. However, mechanisms to improve retention need special attention.
Description
CITATION: Madhombiro, M., et al. 2019. Intervention for alcohol use disorders at an HIV care clinic in Harare : a pilot and feasibility study. Addiction Science and Clinical Practice, 14:16, doi:10.1186/s13722-019-0143-7.
The original publication is available at https://ascpjournal.biomedcentral.com
The original publication is available at https://ascpjournal.biomedcentral.com
Keywords
HIV-positive persons -- Alcohol use -- Harare (Zimbabwe), HIV-positive persons -- Psychological aspects -- Harare (Zimbabwe), Patient compliance -- Harare (Zimbabwe)
Citation
Madhombiro, M., et al. 2019. Intervention for alcohol use disorders at an HIV care clinic in Harare : a pilot and feasibility study. Addiction Science and Clinical Practice, 14:16, doi:10.1186/s13722-019-0143-7