Behavioral Interventions Targeting Alcohol Use Among People Living with HIV/AIDS: A Systematic Review and Meta-Analysis

Abstract

Alcohol use is often reported among people living with HIV/AIDS (PLWHA) and is associated with increased sexual risk and poor medication adherence. This meta-analysis evaluated the efficacy of behavioral interventions addressing alcohol use among PLWHA. Twenty-one studies (N = 8,461 PLWHA) that evaluated an individual-level intervention addressing alcohol use alone or as part of a more comprehensive alcohol/HIV intervention, included a control condition, and were available through December 2016 were included. Independent raters coded study, sample, and intervention content. Weighted mean effect sizes, using random-effects models, were calculated. Results indicate that interventions reduced alcohol consumption, increased condom use, and improved medication adherence relative to controls (d+s = 0.10–0.24). Plasma viral load was also reduced in intervention versus control participants (d+ = 0.14, 95% CI = 0.02, 0.26; k= 7). These findings show that behavioral interventions addressing alcohol use can successfully reduce alcohol consumption and also improve HIV-related outcomes among PLWHA.

The Implementation & Sustainment Facilitation Strategy improved implementation effectiveness and intervention effectiveness: Results from a cluster-randomized type 2 hybrid trial

“…We used a cluster-randomized, type 2 hybrid trial to simultaneously test the impact of the ISF strategy (as an adjunct to the ATTC strategy) on: (1) the integration of a MIBI for SUDs within HIV-CBOs across the United States, and (2) the effectiveness of the MIBI (as an adjunct to UC within HIV-CBOs). Contributing to the growing literature on the effectiveness of facilitation-based strategies (74)(75)(76)(77)(78)(79)(80)(81)(82) and the effectiveness of MIBIs for SUD within HIV service settings (18,(83)(84)(85)(86)(87)(88), we found at least two findings of significance. First, we found evidence that the ISF strategy had a significant impact on improving the integration of the MIBI for SUDs, at least in terms of significantly improving the consistency and quality of MIBI implementation during the implementation phase (i.e., implementation effectiveness).…”

The Implementation & Sustainment Facilitation Strategy improved implementation effectiveness and intervention effectiveness: Results from a cluster-randomized type 2 hybrid trial

“…We used a cluster-randomized, type 2 hybrid trial to simultaneously test the impact of the ISF strategy (as an adjunct to the ATTC strategy) on: (1) the integration of a MIBI for SUDs within HIV-CBOs across the United States, and (2) the effectiveness of the MIBI (as an adjunct to UC within HIV-CBOs). Contributing to the growing literature on the effectiveness of facilitation-based strategies (74)(75)(76)(77)(78)(79)(80)(81)(82) and the effectiveness of MIBIs for SUD within HIV service settings (18,(83)(84)(85)(86)(87)(88), we found at least two findings of significance. First, we found evidence that the ISF strategy had a significant impact on improving the integration of the MIBI for SUDs, at least in terms of significantly improving the consistency and quality of MIBI implementation during the implementation phase (i.e., implementation effectiveness).…”

Implementation and evaluation of SBIRT training in a Community Health nursing course

“…The researcher recommended that SBIRT be included in primary care settings so that identification of a SUD can be made, and timely interventions and referrals implemented. Implementation of SBIRT in HIV treatment settings has been recommended because alcohol use among people living with the disease has been associated with non-adherence to antiretroviral medications and poor health outcomes (Sanchez & Finnell, 2016;Scott-Sheldon, Carey, Johnson, & Carey, 2017)…”

“…Implementation of SBIRT in HIV treatment settings has been recommended because alcohol use among people living with the disease has been associated with non‐adherence to antiretroviral medications and poor health outcomes (Sanchez & Finnell, ; Scott‐Sheldon, Carey, Johnson, & Carey, ). The suggested screening tools for assessing alcohol consumption in this population are either the National Institute of Alcohol Abuse and Alcoholism (NIAAA) and Alcohol Single Question Screen or Alcohol Use Disorder Identification Test (AUDIT) along with a brief intervention or referral to treatment for those individuals with a positive screen (World Health Organization, ).…”