Abstract
Unhealthy alcohol use and HIV risk often co-occur. To intervene on this association, we are conducting a pilot study to determine the feasibility and impact of providing brief alcohol- and sexual-risk reduction counseling with rapid HIV testing in a large urban emergency department (ED). We are recruiting ED patients aged 18-40 years who 1) meet National Institute on Alcohol Abuse and Alcoholism criteria for at-risk drinking, 2) have >1 sexual-risk behavior, 3) have negative or unknown HIV status, and 4) are willing to undergo HIV testing. We are conducting a brief, manual-guided intervention combining an alcohol- and sexual-risk reduction counseling session with rapid HIV testing followed by a booster telephone call at two weeks. At baseline and eight weeks, we assess alcohol consumption with the Timeline Follow-Back for alcohol consumption and a modified HIV Risk Behavior Scale to characterize sexual risk behaviors. Statistical analyses include Wilcoxon Signed Rank test, McNemar test, and two-way ANOVA. Of the 82 participants enrolled to date, 60% are male, the mean age is 25 years, 63% are white, 83% are unmarried, 59% are college-educated, 41% are without primary care, and 79% have an AUDIT score of >8. All tested HIV negative. Among the 62 with follow-up data so far, alcohol consumption decreased with fewer average weekly drinks (25.5 versus 10.4, p < 0.0001) and binge drinking episodes (2.03 versus 0.99, p < 0.0001). This decrease was greater in men than women (p < 0.0002). Post-intervention, participants endorsed increased condom use (median change = 3 points on a 5-point scale, W = 275, p < 0.0001) and decreased episodes of sex while intoxicated (RR = 0.14, p < 0.0001). Mean intervention duration was 44 minutes. Preliminary analyses demonstrate that a brief intervention combining alcohol- and sexual-risk reduction counseling with rapid HIV testing in the ED is feasible and effective for reducing alcohol use and HIV risk behaviors among young unhealthy drinkers.
Highlights
Unhealthy alcohol use and HIV risk often co-occur
We are conducting a brief, manual-guided intervention combining an alcoholand sexual-risk reduction counseling session with rapid HIV testing followed by a booster telephone call at two weeks
Among the 62 with follow-up data so far, alcohol consumption decreased with fewer average weekly drinks (25.5 versus 10.4, p < 0.0001) and binge drinking episodes (2.03 versus 0.99, p < 0.0001)
Summary
Unhealthy alcohol use and HIV risk often co-occur. To intervene on this association, we are conducting a pilot study to determine the feasibility and impact of providing brief alcohol- and sexual-risk reduction counseling with rapid HIV testing in a large urban emergency department (ED). Project ART-ED: alcohol reduction and HIV testing in the emergency department From International Network on Brief Interventions for Alcohol and Other Drugs (INEBRIA) Meeting 2011 Boston, MA, USA.
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