Heavy alcohol use in HIV-infected patients may lead to lower adherence to antiretrovirai therapy, greater sexual risk taking, higher viral loads, worse liver functioning, jand worse cognitive functioning. Therefore, interventions to reduce drinking may have particularly positive and widespread effects in HIV-infected patients. Men who have sex with men (MSM) continue to represent almost half of all HIV/AIDS cases in the US, and rates of excessive drinking are particularly high among HIV-infected MSM. Although brief interventions have been shown to reduce alcohol consumption in general primary care settings, the efficacy of brief alcohol interventions in HIV primary care settings has not been established, and no brief alcohol interventions have been tested specifically in a population of HIV-infected MSM. Furthermore, there currently are no data published on the extent to which changes in alcohol use after a brief intervention relate to key HIV-related outcomes (viral, immunologic, hepatic, neurocognitive, and behavioral). The overall aim of this project is to test the efficacy of a brief alcohol intervention for HIV-infected MSM in a primary care setting. This randomized clinical trial uses a 2 group between-subjects design with repeated measures to compare treatment as usual (TAU) to TAU plus a brief intervention to reduce alcohol use (TAUBI). Participants will be 224 heavy drinking HIV-infected MSM receiving care at the Fenway Community Health clinic in Boston. Those assigned to TAU-BI will receive one 60-minute session of in-person counseling and two booster sessions by telephone. Sessions will provide feedback and advice on alcohol use in the context of HIV treatment and will use Motivational Interviewing to develop discrepancies between current drinking behavior and long-term health. Participants will be interviewed at 3, 6, and 12 months. Primary analyses will test the hypotheses (a) that TAU-BI will result in reduced drinking relative to TAU and (b) that greater reductions in alcohol use will be associated with greater adherence to HIV medications, less high-risk sexual behavior, and better viral, hepatic, and neurocognitive outcomes. Secondary and tertiary aims will examine mediation and moderation of TAU-BI effects on these HIV-related outcomes.

Public Health Relevance

This project will help establish an efficacious approach for addressing heavy drinking in HIV-infected MSM in primary care settings. It also will provide valuable insights on the effects of reductions in alcohol use on unsafe sex, medication adherence, and viral, liver, and brain outcomes in HIV-infected patients.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Program Projects (P01)
Project #
1P01AA019072-01
Application #
7842296
Study Section
Special Emphasis Panel (ZAA1-BB (93))
Project Start
Project End
Budget Start
2010-09-30
Budget End
2010-10-31
Support Year
1
Fiscal Year
2010
Total Cost
$365,731
Indirect Cost
Name
Brown University
Department
Type
DUNS #
001785542
City
Providence
State
RI
Country
United States
Zip Code
02912
Nunn, Amy; Parker, Sharon; McCoy, Katryna et al. (2018) African American Clergy Perspectives About the HIV Care Continuum: Results From a Qualitative Study in Jackson, Mississippi. Ethn Dis 28:85-92
Cohen, Ronald A; Siegel, S; Gullett, J M et al. (2018) Neural response to working memory demand predicts neurocognitive deficits in HIV. J Neurovirol 24:291-304
Laws, M Barton; Magill, Molly; Mastroleo, Nadine R et al. (2018) A sequential analysis of motivational interviewing technical skills and client responses. J Subst Abuse Treat 92:27-34
Barry, Declan T; Marshall, Brandon D L; Becker, William C et al. (2018) Duration of opioid prescriptions predicts incident nonmedical use of prescription opioids among U.S. veterans receiving medical care. Drug Alcohol Depend 191:348-354
Kahler, Christopher W; Pantalone, David W; Mastroleo, Nadine R et al. (2018) Motivational interviewing with personalized feedback to reduce alcohol use in HIV-infected men who have sex with men: A randomized controlled trial. J Consult Clin Psychol 86:645-656
Pérez, Ashley E; Wray, Tyler B; Celio, Mark A et al. (2018) HIV-related thought avoidance, sexual risk, and alcohol use among men who have sex with men. AIDS Care 30:930-935
Wray, Tyler B; Adia, Alexander C; Pérez, Ashley E et al. (2018) Timeline: A web application for assessing the timing and details of health behaviors. Am J Drug Alcohol Abuse :1-10
Wray, Tyler B; Chan, Philip A; Celio, Mark A et al. (2018) HIV Testing Among Men Who Have Sex with Men in the Northeastern United States. AIDS Behav 22:531-537
Sileo, Katelyn M; Kintu, Michael; Kiene, Susan M (2018) The intersection of intimate partner violence and HIV risk among women engaging in transactional sex in Ugandan fishing villages. AIDS Care 30:444-452
Gullett, Joseph M; Lamb, Damon G; Porges, Eric et al. (2018) The Impact of Alcohol Use on Frontal White Matter in HIV. Alcohol Clin Exp Res 42:1640-1649

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