Abstract
BackgroundAlcohol abuse comes with risks for increased morbidity and mortality among patients with HIV. This study aims to determine the prevalence of alcohol use and other risk factors in a sample of primary care patients with HIV in South Africa and to assess a brief intervention to reduce the use of alcohol in this group.Methods/DesignA single-blinded randomized controlled trial is designed to determine the efficacy of a brief intervention to reduce hazardous alcohol use in patients with HIV. The study will be carried out on out-patients with HIV in two primary healthcare HIV clinics near Pretoria, South Africa. Alcohol use will be assessed with the Alcohol Use Disorder Identification Test questionnaire. Other data that will be collected relate to health-related quality of life, depression, sexual behavior, internalized AIDS stigma, HIV-related information and adherence to antiretroviral therapy (self-reported 7-day recall of missed doses, Visual Analog Scale and pill count). The intervention consists of a brief counseling session to reduce alcohol risk; the control group receives a health education leaflet.DiscussionThe findings will be important in the public health setting. If the intervention proves to be efficient, it could potentially be incorporated into the HIV care policy of the Ministry of Health.Trial registrationPan African Clinical trial Registry: PACTR201202000355384
Highlights
Alcohol abuse comes with risks for increased morbidity and mortality among patients with human immunodeficiency syndrome (HIV)
If the intervention proves to be efficient, it could potentially be incorporated into the HIV care policy of the Ministry of Health
Studies in several African countries have shown a causal link between alcohol use and HIV, and have shown that alcohol use has effects on the course of HIV, including adherence to antiretroviral therapy (ART)
Summary
The use of alcohol in South Africa is among the highest in Africa [1] with a total adult per-capita consumption of 9.5 l pure alcohol per year, and a consumption of 34.91 l pure alcohol per year (men 39.64 l, women 23.84 l) among people that drink alcohol [2]. One study performed in New York showed improvement in self-report and biological markers (CD4 cell count and HIV viral load) after an eightsession behavioral intervention after 3 months. This result was not sustained at 6 months [26]. One study describes an intervention based on a culturally adapted, six-session (over a 3-month period) cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in western Kenya, whereby the percentages of days abstinent from alcohol before session 1 were 52 to 100% for women and 21 to 36% for men. This study will measure the prevalence of alcohol use in patients with HIV and assess the efficacy of a brief intervention to reduce alcohol use among selected patients
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