TY - JOUR
T1 - Integrated stepped alcohol treatment for patients with HIV and at-risk alcohol use
T2 - a randomized trial
AU - Edelman, E. Jennifer
AU - Maisto, Stephen A.
AU - Hansen, Nathan B.
AU - Cutter, Christopher J.
AU - Dziura, James
AU - Deng, Yanhong
AU - Fiellin, Lynn E.
AU - O'connor, Patrick G.
AU - Bedimo, Roger
AU - Gibert, Cynthia L.
AU - Marconi, Vincent C.
AU - Rimland, David
AU - Rodriguez-Barradas, Maria C.
AU - Simberkoff, Michael S.
AU - Tate, Janet P.
AU - Justice, Amy C.
AU - Bryant, Kendall J.
AU - Fiellin, David A.
N1 - Publisher Copyright:
© 2020 The Author(s).
PY - 2020/7/29
Y1 - 2020/7/29
N2 - Background: At-risk levels of alcohol use threaten the health of patients with HIV (PWH), yet evidence-based strategies to decrease alcohol use and improve HIV-related outcomes in this population are lacking. We examined the effectiveness of integrated stepped alcohol treatment (ISAT) on alcohol use and HIV outcomes among PWH and at-risk alcohol use. Methods: In this multi-site, randomized trial conducted between January 28, 2013 through July 14, 2017, we enrolled PWH and at-risk alcohol use [defined as alcohol consumption of ≥ 14 drinks per week or ≥ 4 drinks per occasion in men ≤ 65 years old or ≥ 7 drinks per week or ≥ 3 drinks per occasion in women or men > 65 years old]. ISAT (n = 46) involved: Step 1- Brief Negotiated Interview with telephone booster, Step 2- Motivational Enhancement Therapy, and Step 3- Addiction Physician Management. Treatment as usual (TAU) (n = 47) involved receipt of a health handout plus routine care. Analyses were conducted based on intention to treat principles. Results: Despite a multi-pronged approach, we only recruited 37% of the target population (n = 93/254). Among ISAT participants, 50% advanced to Step 2, among whom 57% advanced to Step 3. Participants randomized to ISAT and TAU had no observed difference in drinks per week over the past 30 days at week 24 (primary outcome) [least square means (Ls mean) (95% CI) = 8.8 vs. 10.6; adjusted mean difference (AMD) (95% CI) = - 0.4 (- 3.9, 3.0)]. Conclusion: An insufficient number of patients were interested in participating in the trial. Efforts to enhance motivation of PWH with at-risk alcohol use to engage in alcohol-related research and build upon ISAT are needed. Trial registration Clinicaltrials.gov:
AB - Background: At-risk levels of alcohol use threaten the health of patients with HIV (PWH), yet evidence-based strategies to decrease alcohol use and improve HIV-related outcomes in this population are lacking. We examined the effectiveness of integrated stepped alcohol treatment (ISAT) on alcohol use and HIV outcomes among PWH and at-risk alcohol use. Methods: In this multi-site, randomized trial conducted between January 28, 2013 through July 14, 2017, we enrolled PWH and at-risk alcohol use [defined as alcohol consumption of ≥ 14 drinks per week or ≥ 4 drinks per occasion in men ≤ 65 years old or ≥ 7 drinks per week or ≥ 3 drinks per occasion in women or men > 65 years old]. ISAT (n = 46) involved: Step 1- Brief Negotiated Interview with telephone booster, Step 2- Motivational Enhancement Therapy, and Step 3- Addiction Physician Management. Treatment as usual (TAU) (n = 47) involved receipt of a health handout plus routine care. Analyses were conducted based on intention to treat principles. Results: Despite a multi-pronged approach, we only recruited 37% of the target population (n = 93/254). Among ISAT participants, 50% advanced to Step 2, among whom 57% advanced to Step 3. Participants randomized to ISAT and TAU had no observed difference in drinks per week over the past 30 days at week 24 (primary outcome) [least square means (Ls mean) (95% CI) = 8.8 vs. 10.6; adjusted mean difference (AMD) (95% CI) = - 0.4 (- 3.9, 3.0)]. Conclusion: An insufficient number of patients were interested in participating in the trial. Efforts to enhance motivation of PWH with at-risk alcohol use to engage in alcohol-related research and build upon ISAT are needed. Trial registration Clinicaltrials.gov:
KW - Alcohol-related disorders
KW - Delivery of health care
KW - HIV
KW - Integrated
UR - http://www.scopus.com/inward/record.url?scp=85088852111&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85088852111&partnerID=8YFLogxK
U2 - 10.1186/s13722-020-00200-y
DO - 10.1186/s13722-020-00200-y
M3 - Article
C2 - 32727618
AN - SCOPUS:85088852111
SN - 1940-0632
VL - 15
JO - Addiction Science and Clinical Practice
JF - Addiction Science and Clinical Practice
IS - 1
M1 - 28
ER -