The effect of a brief intervention and motivational interviewing on alcohol misuse and anti-retroviral therapy adherence in patients with human immuno-deficiency virus and a history of alcohol misuse: a systematic review protocol

Abstract

Background Problem level alcohol consumption is a common issue in the treatment of People Living with HIV (PLHIV) infection. Alcohol consumption has been linked to lower rates of adherence to Highly Active Antiretroviaral Therapy (HAART). There is no previous synthesis done on the effects of interventions on people with HIV with the history alcohol use problems. Objectives The objective of this review is to determine the effect of a brief intervention and motivational Interview on alcohol misuse and HAART adherence in patients with human immunodeficiency virus and a history of alcohol problems. Inclusion criteria Types of participants People Living with HIV with history of alcohol use problems Types of intervention Motivational interview, and/or brief intervention, and/or cognitive behavioral therapy or all these interventions Types of studies This review will include both experimental and observational study designs. Types of outcomes Viral load, CD4 cell count, and ART adherence and drinking behavior Search strategy In order to find both published and unpublished studies, a three-step search strategy will be utilised in this review. An initial limited search of MEDLINE and CINAHL will be undertaken. A second search using all identified keywords and index terms will then be undertaken across all included databases. Thirdly, the reference list of all identified reports and articles will be searched for additional studies. Methodological quality Papers selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Data collection Data will be extracted from papers included in the review using the standardized data extraction tool from JBI-MAStARI. Data synthesis Quantitative data will, where possible be pooled in statistical meta-analysis using JBI-MAStARI. Effect sizes expressed as odds ratio and weighted mean differences and their 95% confidence intervals will be calculated for analysis. Heterogeneity will be assessed statistically using the standard Chi-square and also explored using subgroup analyses based on the different study designs included in this review.