A cluster randomised-controlled trial for alcohol-use disorders in HIV care clinics

Tags: Poster
Madhombiro M1
1University of Zimbabwe

Background:Interventions for alcohol-use disorders (AUDs) in HIV-infected individuals have been primarily targeted for HIV risk reduction and improved antiretroviral treatment adherence. However, reduction in alcohol use is an important goal. Alcohol use affects other key factors that may influence treatment course and outcome. In this study the authors aim to administer an adapted intervention for AUDs to reduce alcohol use in people living with HIV/AIDS (PLWHA).

Methods: A motivational interviewing and cognitive behavioural therapy based intervention for AUDs, developed through adaptation and piloted in Zimbabwe, will be administered to PLWHA with AUDs recruited at 8 HIV clinics in a cluster randomised-controlled trial. This intervention will be compared with an equal attention control in the form of the WHO mhGAP guide, adapted for the Zimbabwean context. The primary outcome measure will be the Alcohol Use Disorder Identification Test (AUDIT) score. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), World Health Organization Quality of Life (WHOQoL) HIV, viral load, and CD4 counts will be secondary outcome measures. Data will be analysed using STATA Version 14. Primary and secondary outcomes will be measured at 4 time points that is; at baseline, 3, 6 and 12 months respectively. All participants will be included in the analysis of primary and secondary outcome measures. The mean AUDIT scores will be compared between groups using student t-tests. Multilevel logistic-regression analysis will be performed for binominal variables and multilevel linear regression for continuous variables. Descriptive statistics will be computed for baseline and follow-up assessments.

Conclusions: The study will be the first to address problematic alcohol use in PLWHA in Zimbabwe. The study results will determine the effectiveness of adapting psychological interventions for AUDs in HIV-infected adults using a task-sharing framework for people living with HIV/AIDS in Zimbabwe.