Efficacy of an alcohol-focused intervention for improving adherence to antiretroviral therapy (ART) and HIV treatment outcomes – a randomised controlled trial protocol

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dc.contributor.authorParry, Charles D
dc.contributor.authorMorojele, Neo K
dc.contributor.authorMyers, Bronwyn J
dc.contributor.authorKekwaletswe, Connie T
dc.contributor.authorManda, Samuel O
dc.contributor.authorSorsdahl, Katherine
dc.contributor.authorRamjee, Gita
dc.contributor.authorHahn, Judith A
dc.contributor.authorRehm, Jürgen
dc.contributor.authorShuper, Paul A
dc.date.accessioned2015-06-30T12:11:38Z
dc.date.available2015-06-30T12:11:38Z
dc.date.issued2014-09-12
dc.date.updated2015-01-15T17:59:03Z
dc.description.abstractAbstract Background Little research has examined whether alcohol reduction interventions improve antiretroviral therapy (ART) adherence and HIV treatment outcomes. This study assesses the efficacy of an intervention for reducing alcohol use among HIV patients on ART who are hazardous/harmful drinkers. Specific aims include adapting a blended Motivational Interviewing (MI) and Problem Solving Therapy (PST) intervention for use with HIV patients; evaluating the efficacy of the intervention for reducing alcohol consumption; and assessing counsellors’ and participants’ perceptions of the intervention. Methods/Design A randomised controlled trial will evaluate the intervention among ART patients in public hospital-based HIV clinics in Tshwane, South Africa. We will recruit patients who are HIV-positive, on ART for at least 3 months, and classified as harmful/hazardous drinkers using the AUDIT-3. Eligible patients will be randomly assigned to one of three conditions. Patients in the experimental group will receive the MI-PST intervention to reduce harmful/hazardous alcohol use. Patients in the equal-attention wellness intervention group will receive an intervention focused on addressing health risk behaviours. Patients in the control condition will receive treatment as usual. Participants will complete an interviewer-administered questionnaire at baseline and 3, 6 and 12 months post-randomisation to assess alcohol consumption, ART adherence, physical and mental health. We will also collect biological specimens to test for recent alcohol consumption, CD4 counts and HIV RNA viral loads. The primary outcome will be reduction in the volume of alcohol consumed. Secondary outcomes include reduction in harmful/hazardous use of alcohol, reduction in biological markers of drinking, increase in adherence rates, reductions in viral loads, and increases in CD4 T-cell counts. A process evaluation will ascertain counsellors’ and participants’ perceptions of the acceptability and effectiveness of the interventions. Discussion We have obtained ethical approval and approval from the study sites and regional and provincial health departments. The study has implications for clinicians, researchers and policy makers as it will provide efficacy data on how to reduce harmful/hazardous alcohol consumption among HIV patients and will shed light on whether reducing alcohol consumption impacts on HIV treatment adherence and other outcomes. Trial registration Pan African Clinical Trials Register Number: PACTR201405000815100 .
dc.identifier.apacitationParry, C. D., Morojele, N. K., Myers, B. J., Kekwaletswe, C. T., Manda, S. O., Sorsdahl, K., ... Shuper, P. A. (2014). Efficacy of an alcohol-focused intervention for improving adherence to antiretroviral therapy (ART) and HIV treatment outcomes – a randomised controlled trial protocol. <i>BMC Infectious Diseases</i>, http://hdl.handle.net/11427/13192en_ZA
dc.identifier.chicagocitationParry, Charles D, Neo K Morojele, Bronwyn J Myers, Connie T Kekwaletswe, Samuel O Manda, Katherine Sorsdahl, Gita Ramjee, Judith A Hahn, Jürgen Rehm, and Paul A Shuper "Efficacy of an alcohol-focused intervention for improving adherence to antiretroviral therapy (ART) and HIV treatment outcomes – a randomised controlled trial protocol." <i>BMC Infectious Diseases</i> (2014) http://hdl.handle.net/11427/13192en_ZA
dc.identifier.citationParry, C. D., Morojele, N. K., Myers, B. J., Kekwaletswe, C. T., Manda, S. O., Sorsdahl, K., ... & Shuper, P. A. (2014). Efficacy of an alcohol-focused intervention for improving adherence to antiretroviral therapy (ART) and HIV treatment outcomes-a randomised controlled trial protocol. BMC infectious diseases, 14(1), 500.
dc.identifier.ris TY - Journal Article AU - Parry, Charles D AU - Morojele, Neo K AU - Myers, Bronwyn J AU - Kekwaletswe, Connie T AU - Manda, Samuel O AU - Sorsdahl, Katherine AU - Ramjee, Gita AU - Hahn, Judith A AU - Rehm, Jürgen AU - Shuper, Paul A AB - Abstract Background Little research has examined whether alcohol reduction interventions improve antiretroviral therapy (ART) adherence and HIV treatment outcomes. This study assesses the efficacy of an intervention for reducing alcohol use among HIV patients on ART who are hazardous/harmful drinkers. Specific aims include adapting a blended Motivational Interviewing (MI) and Problem Solving Therapy (PST) intervention for use with HIV patients; evaluating the efficacy of the intervention for reducing alcohol consumption; and assessing counsellors’ and participants’ perceptions of the intervention. Methods/Design A randomised controlled trial will evaluate the intervention among ART patients in public hospital-based HIV clinics in Tshwane, South Africa. We will recruit patients who are HIV-positive, on ART for at least 3 months, and classified as harmful/hazardous drinkers using the AUDIT-3. Eligible patients will be randomly assigned to one of three conditions. Patients in the experimental group will receive the MI-PST intervention to reduce harmful/hazardous alcohol use. Patients in the equal-attention wellness intervention group will receive an intervention focused on addressing health risk behaviours. Patients in the control condition will receive treatment as usual. Participants will complete an interviewer-administered questionnaire at baseline and 3, 6 and 12 months post-randomisation to assess alcohol consumption, ART adherence, physical and mental health. We will also collect biological specimens to test for recent alcohol consumption, CD4 counts and HIV RNA viral loads. The primary outcome will be reduction in the volume of alcohol consumed. Secondary outcomes include reduction in harmful/hazardous use of alcohol, reduction in biological markers of drinking, increase in adherence rates, reductions in viral loads, and increases in CD4 T-cell counts. A process evaluation will ascertain counsellors’ and participants’ perceptions of the acceptability and effectiveness of the interventions. Discussion We have obtained ethical approval and approval from the study sites and regional and provincial health departments. The study has implications for clinicians, researchers and policy makers as it will provide efficacy data on how to reduce harmful/hazardous alcohol consumption among HIV patients and will shed light on whether reducing alcohol consumption impacts on HIV treatment adherence and other outcomes. Trial registration Pan African Clinical Trials Register Number: PACTR201405000815100 . DA - 2014-09-12 DB - OpenUCT DO - 10.1186/1471-2334-14-500 DP - University of Cape Town J1 - BMC Infectious Diseases LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - Efficacy of an alcohol-focused intervention for improving adherence to antiretroviral therapy (ART) and HIV treatment outcomes – a randomised controlled trial protocol TI - Efficacy of an alcohol-focused intervention for improving adherence to antiretroviral therapy (ART) and HIV treatment outcomes – a randomised controlled trial protocol UR - http://hdl.handle.net/11427/13192 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/13192
dc.identifier.urihttp://dx.doi.org/10.1186/1471-2334-14-500
dc.identifier.vancouvercitationParry CD, Morojele NK, Myers BJ, Kekwaletswe CT, Manda SO, Sorsdahl K, et al. Efficacy of an alcohol-focused intervention for improving adherence to antiretroviral therapy (ART) and HIV treatment outcomes – a randomised controlled trial protocol. BMC Infectious Diseases. 2014; http://hdl.handle.net/11427/13192.en_ZA
dc.language.rfc3066en
dc.publisher.departmentDepartment of Psychiatry and Mental Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution License*
dc.rights.holderParry et al.; licensee BioMed Central Ltd.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0*
dc.sourceBMC Infectious Diseasesen_ZA
dc.source.urihttp://www.biomedcentral.com/bmcinfectdis/
dc.subject.otherHIV/AIDSen_ZA
dc.subject.otherAlcoholen_ZA
dc.subject.otherSouth Africaen_ZA
dc.subject.otherRandomised controlled trialen_ZA
dc.subject.otherBrief interventionen_ZA
dc.titleEfficacy of an alcohol-focused intervention for improving adherence to antiretroviral therapy (ART) and HIV treatment outcomes – a randomised controlled trial protocol
dc.typeJournal Articleen_ZA
uct.type.filetype
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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