Brief Intervention Decreases Drinking Frequency in HIV-Infected, Heavy Drinking Women

Abstract

Objective Hazardous alcohol use by HIV-infected women is associated with poor HIV outcomes and HIV transmission risk behaviors. We examined the effectiveness of brief alcohol intervention (BI) among hazardous drinking women receiving care in an urban, HIV clinic. Methods Women were randomized to a 2-session BI or usual care. Outcomes assessed at baseline, 3, 6 and 12 months included 90-day frequency of any alcohol use and heavy/binge drinking (≥4 drinks per occasion), and average drinks per drinking episode. Secondary outcomes included HIV medication and appointment adherence, HIV1-RNA suppression, and days of unprotected vaginal sex. We examined intervention effectiveness using generalized mixed effect models and quantile regression. Results Of 148 eligible women, 74 were randomized to each arm. In mixed effects models, 90-day drinking frequency decreased among intervention group compared to control, with women in the intervention condition less likely to have a drinking day (OR: 0.42 (95% CI: 0.23–0.75). Heavy/binge drinking days and drinks per drinking day did not differ significantly between groups. Quantile regression demonstrated a decrease in drinking frequency in the middle to upper ranges of the distribution of drinking days and heavy/binge drinking days that differed significantly between intervention and control conditions. At follow-up, the intervention group had significantly fewer episodes of unprotected vaginal sex. No intervention effects were observed for other outcomes. Conclusions Brief alcohol intervention reduces frequency of alcohol use and unprotected vaginal sex among HIV-infected women. More intensive services may be needed to lower drinks per drinking day and enhance care for more severely affected drinkers.

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

“…Measures of alcohol use included (a) proportion of participants who consumed alcohol, (b) frequency of drinking days, (c) quantity of alcohol consumed, and (d) heavy episodic drinking (i.e., defined as 5 [4] or more drinks per occasion for men [women] over a period of time (30–90 days) (16–18). We also determined the efficacy of each intervention to reduce sexual risk behaviors (i.e., number of sexual partners, condom use, and sexual risk composite).…”

The role of personal and household members’ substance use in health-related quality of life in women living with HIV/AIDS

“…Consequently, HIV care providers may be missing an important barrier to quality of life among women living with HIV. Results from a recent clinical trial suggest that on-site brief alcohol intervention may provide an effective and easily implemented treatment option for women living with HIV/AIDS(Chander et al, 2015). Our findings on mental HRQOL provide further rationale for the implementation of universal screening and alcohol and drug interventions in the HIV clinic setting.…”

“…We used baseline data from a randomized clinical trial (RCT) of brief alcohol intervention among hazardous drinking HIV infected women (n=148) (Chander, Hutton, Lau, Xu, & McCaul, 2015) and a cohort of predominantly non-hazardous drinking women (n=240) recruited concurrently with RCT participants from the same urban HIV outpatient clinic. Women were recruited between March 2006 and September 2010 through clinic flyers, waiting room recruitment, and provider referral (Barai et al, 2016; Chander et al, 2015).…”

“…Women were recruited between March 2006 and September 2010 through clinic flyers, waiting room recruitment, and provider referral (Barai et al, 2016; Chander et al, 2015). To be eligible for the RCT, women had to be HIV infected and receiving care in the HIV Clinic, report at-risk drinking behavior (defined as >7 standard drinks per week or two or more heavy drinking episodes) in the past 6 months or have a TWEAK score ≥2 (Tolerance, Worried, Eye-opener, Amnesia, K/Cut Down is a five-item scale developed originally to screen for risk drinking during pregnancy) (Russell, 1994).…”

Brief Intervention for Risky Alcohol Use: A Critical Analysis

“…Although very limited in number and methodological quality, there is some evidence on brief intervention for heavy drinkings such as psychiatric outpatient setting, [45] community-based counselling centres, sexual health clinics, and antenatal care and postpartum care settings [46][47][48][49]. However, none of the studies reported a superior benefit for brief intervention as compared to routine care [50,51].…”