Evaluating the effects of two alcohol reduction counseling interventions on intimate partner violence perpetration: secondary analysis of a three-arm randomized controlled trial among Vietnamese men with HIV.

Abstract

Evidence suggests that alcohol reduction interventions decrease intimate partner violence (IPV) perpetration, although this remains untested in low- and middle-income countries and among men with human immunodeficiency virus (HIV). This study evaluates the effectiveness of alcohol reduction counseling interventions on IPV perpetration among men on anti-retroviral therapy (ART) and tests whether alcohol use explains the intervention effects. Secondary analysis of data from a three-arm randomized controlled trial among ART patients with hazardous alcohol use. Participants were recruited from March 2016 to May 2017. Thai Nguyen, Vietnam. Male participants (n=426). Participants received a two-session brief intervention (BI), a six-session combined intervention (CoI) or the standard of care (SOC), comprising alcohol treatment referrals. Alcohol reduction counseling interventions were guided by cognitive-behavioral therapy and motivational enhancement therapy delivered by psychosocial counselors over 3months. IPV perpetration was measured using the shortened Conflict Tactics Scale 2 and alcohol use was measured using timeline followback. BI and CoI participants reported reduced IPV perpetration at 3months compared with SOC participants [BI: adjusted odds ratio (aOR)=0.27, 95% confidence interval (CI)=0.11, 0.65; CoI: aOR=0.50, 95% CI=0.22, 1.13]; the association was only significant for the BI group. Intervention effects were not sustained at 6 and 12months. There was little evidence that alcohol use acted as a mediator (indirect effect, BI: aOR=0.84, 95% CI=0.63, 1.04; indirect effect, CoI: aOR=0.86, 95% CI=0.66, 1.03). Among Vietnamese men receiving anti-retroviral therapy, alcohol reduction counseling interventions appeared to reduce intimate partner violence perpetration immediately post-intervention, but reductions were not sustained at 6 and 12months and were not explained by alcohol reduction.