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 #
5P01AA019072-03
Application #
8379799
Study Section
Special Emphasis Panel (ZAA1-DD)
Project Start
Project End
Budget Start
2012-09-01
Budget End
2013-08-31
Support Year
3
Fiscal Year
2012
Total Cost
$364,445
Indirect Cost
$46,202
Name
Brown University
Department
Type
DUNS #
001785542
City
Providence
State
RI
Country
United States
Zip Code
02912
Wray, Tyler B; Pantalone, David W; Kahler, Christopher W et al. (2016) The role of discrimination in alcohol-related problems in samples of heavy drinking HIV-negative and positive men who have sex with men (MSM). Drug Alcohol Depend 166:226-34
Li, Ming; Ramratnam, Bharat (2016) Proteomic Characterization of Exosomes from HIV-1-Infected Cells. Methods Mol Biol 1354:311-26
Midoun, Miriam; Shangani, Sylvia; Mbete, Bibi et al. (2016) How intersectional constructions of sexuality, culture, and masculinity shape identities and sexual decision-making among men who have sex with men in coastal Kenya. Cult Health Sex 18:625-38
Cioe, Patricia A; Gamarel, Kristi E; Pantalone, David W et al. (2016) Cigarette Smoking and Antiretroviral Therapy (ART) Adherence in a Sample of Heavy Drinking HIV-Infected Men Who Have Sex with Men (MSM). AIDS Behav :
Monnig, Mollie A; Kahler, Christopher W; Cioe, Patricia A et al. (2016) Alcohol use predicts elevation in inflammatory marker soluble CD14 in men living with HIV. AIDS Care 28:1434-40
Banerjee, Geetanjoli; Edelman, E Jennifer; Barry, Declan T et al. (2016) Non-medical use of prescription opioids is associated with heroin initiation among US veterans: a prospective cohort study. Addiction 111:2021-2031
Woods, Adam J; Porges, Eric C; Bryant, Vaughn E et al. (2016) Current Heavy Alcohol Consumption is Associated with Greater Cognitive Impairment in Older Adults. Alcohol Clin Exp Res 40:2435-2444
Wray, Tyler B; Grin, Benjamin; Dorfman, Leah et al. (2016) Systematic review of interventions to reduce problematic alcohol use in men who have sex with men. Drug Alcohol Rev 35:148-57
Okafor, Chukwuemeka N; Kelso, Natalie E; Bryant, Vaughn et al. (2016) Body mass index, inflammatory biomarkers and neurocognitive impairment in HIV-infected persons. Psychol Health Med :1-14
Kahler, Christopher W; Liu, Tao; Cioe, Patricia A et al. (2016) Direct and Indirect Effects of Heavy Alcohol Use on Clinical Outcomes in a Longitudinal Study of HIV Patients on ART. AIDS Behav :

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