The objective of the proposed research is test the feasibility of a brief computer-based personalized feedback intervention to reduce heavy alcohol use among HIV+ individuals. Rates of hazardous alcohol use among HIV+ individuals are approximately two times that found in the general population. Hazardous alcohol use contributes to problems with HIV medication adherence, risky sexual behavior, and psychological problems, as well as physical complications (rapid disease progression, medication toxicities, organ failure, and poor viremic control), which may lead to increased risk of transmission and premature death. Yet, HIV+ hazardous alcohol users remain a hard-to-reach and underserved group. There is therefore a critical need to test alternative approaches to the implementation of effective interventions to reduce HIV disease transmission and progression in HIV+ hazardous alcohol users. One novel and promising intervention approach is the use of personalized feedback, which has consistently been found to be efficacious for reducing hazardous alcohol use across a number of populations. Personalized feedback highlights discrepancies between one's own drinking and typical drinking; reframes use in terms of personal, social, financial, health, and other consequences; and offers strategies for reducing use and alcohol-related negative consequences. The proposed research will develop and evaluate the feasibility, acceptability, and potential efficacy of a novel evidence- and computer-based Personalized Feedback Intervention (PFI) among HIV+ hazardous alcohol users in a high volume Houston HIV clinic. The research will include two primary aims.
The first aim focuses on development and refinement of an intervention adapted from investigators' previous work to incorporate feedback for HIV+ individuals. Feasibility and acceptability will be established through iterative incorporation of focus group feedback regarding recruitment, assessment, and intervention procedures.
The second aim will pilot the intervention to evaluate feasibility and potential efficacy. Outcomes include drinking change processes and behavior, alcohol-related risky sexual behavior, and HIV-related outcomes. The pilot will recruit 150 HIV+ hazardous alcohol users from clinic waiting areas. Participants will be randomly assigned to receive the PFI or to receive feedback unrelated to alcohol use. An underlying premise which will be evaluated through the aims is that the difficulty in reaching hazardous alcohol users who are HIV+ can be addressed with an approach that will not be burdensome to the individuals or to clinic staff. All assessments and procedures will take place in the clinic on tablets or laptop computers. Follow-up assessments will occur at 3 months post-baseline. This research builds on the collaborative work of an experienced team of investigators with complementary expertise supporting all aspects of the proposed research.
Rates of hazardous alcohol use among HIV+ individuals are approximately two times that found in the general population. Hazardous alcohol use contributes to a variety of problems, ranging from interference with HIV medication adherence to psychological and physical complications. Despite this, HIV+ hazardous alcohol users remain a hard-to-reach and underserved group. The present research proposes to evaluate the efficacy of a brief, computer-based personalized feedback intervention (PFI) to reduce hazardous drinking. PFIs have been found to be cost-effective and efficacious for reducing hazardous alcohol use and related risk behaviors across a number of populations. If effective, this intervention approach will offer a cost-effective means t reach an underserved group of hazardous drinkers and reduce hazardous drinking in this high-risk population.
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