“Moving forward with life’: Perceived acceptability and benefits of a brief alcohol-focused intervention for people receiving antiretroviral therapy in South Africa.

Abstract

Background: In South Africa, like other low-and middle-income countries, interventions are needed to address the impact of hazardous drinking on adherence to antiretroviral therapy among people living with HIV (PLWH). Participant feedback about these interventions can identify ways to enhance their acceptability and potential impact. As part of a randomized controlled trial of a brief motivational interviewing and problem-solving therapy (MI-PST) intervention among PLWH who report hazardous drinking, we interviewed participants about their perceptions of this alcohol-reduction intervention.Methods: The trial was conducted in HIV treatment clinics operating from 6 hospitals in the Tshwane region of South Africa. In the trial, 305 participants were randomly assigned to the intervention comprising four modules of MI-PST delivered over two sessions. We conducted qualitative in-depth interviews of participants’ views about the acceptability and usefulness of the intervention for facilitating behaviour change on completion of the last intervention session and at the six-month study end-point. Twenty-four participants were interviewed after the final intervention session and 25 at the six-month follow up. Data were analysed using the framework approach. Results: Three themes emerged from the interviews that reflect participants’ perceptions of the acceptability and usefulness of this intervention. The first theme describes participants’ perceptions of the acceptability of screening and brief alcohol-focused interventions for PLWH. The second theme describes participants’ views of the usefulness of the intervention for reducing alcohol use and addressing life stressors. The third theme reflects participants’ views on how the intervention could be modified for greater reach and impact.Conclusion: Findings suggest that participants considered this intervention to be acceptable and useful for facilitating reductions in alcohol consumption. This study is the first to describe how PLWH applied the skills taught in the MI-PST intervention to manage and cope with daily problems instead of drinking heavily.