This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Alcohol consumption impacts the course of HIV-infected women on multiple levels. On the molecular level it appears to affect T-lymphocyte counts and antiretroviral pharmacokinetics. On a behavioral level excessive alcohol increases high-risk sexual and injection drug-related behaviors and antiretroviral non-adherence. Brief alcohol interventions have been shown to be effective in decreasing alcohol use and injection-related high-risk behaviors. Women are particularly important targets for alcohol use interventions. The threshold for harmful alcohol effects is strikingly low in women, with two drinks per day placing women at risk for negative health consequences. Brief alcohol interventions are being used in a variety of healthcare settings. Their impact on HIV-infected, hazardous/binge drinking women has yet to be measured. This study seeks to determine the utility of brief alcohol interventions in HIV-infected women in an urban HIV-clinic. Hazardous/binge female drinkers will be identified in the Johns Hopkins Hospital HIV clinic and will be randomized to brief intervention or standard care. Based on Project TrEAT (Trial for Early Alcohol Treatment), the brief intervention will include two sessions that review drinking patterns and behavior change strategies as well as two telephone calls to reinforce session content. Patients in the standard care and the intervention groups will receive the usual care provided by the clinic including medical care, social work referral and treatment referral. Also, patients in both groups will have access to the on-site alcohol support group. Outcome measures will include: alcohol/drug use, engagement in an on-site alcohol support group and other substance abuse treatment services, HIV-risk behaviors, HIV disease markers and treatment compliance, and psychiatric symptoms. Subjects will participate in four assessments: an initial evaluation prior to randomization and at 3-, 6-, and 12-months following study enrollment. Brief interventions are being applied in a wide variety of health care settings. Because women may be less likely to seek and or engage in alcohol treatment services, nontraditional care settings are particularly important for reaching this population. This study will provide information on a practical and easily applied intervention in a clinic setting for the particularly vulnerable population of HIV+ women.
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