HIV Clinical Trial
Official title:
Pharmacotherapy for Hazardous Drinking in HIV Infected Women: Randomized Trial
The purpose of the study is to find out if a medication,naltrexone is helpful for HIV-infected women who sometimes drink too much. The study will try to find out whether women like the medication, whether the medication helps them cut back on their drinking, and whether it helps improve their overall health. Naltrexone has not been used widely among people who are engaged in less severe drinking and in primary health care settings. Therefore, the investigators would like to determine whether it is helpful among women who sometimes drink 4 or more drinks per occasion or 7 or more drinks per week. The investigators hypothesize that by taking naltrexone, women with hazardous drinking pattern will reduce their drinking which in turn will improve their medication adherence, improve their health and quality of life.
The primary objective of this study is to evaluate the acceptability and effectiveness of a
treatment program for hazardous drinking, delivered within HIV-clinic outpatient settings,
that involves oral naltrexone. The central hypothesis is that women randomized to the
treatment program will have decreased rates of hazardous drinking and improved clinical and
behavioral health outcomes that are associated with hazardous drinking. The investigators
have formulated this hypotheses based on the existing literature, the preliminary data and
the clinical experience. The investigators hypothesize that women randomized to receive an
alcohol treatment intervention will be less likely to have hazardous drinking behavior
6-months after enrollment, compared to women who received similar assessments but no formal
treatment intervention. The investigators hypothesize that 4-months after enrollment, women
randomized to receive an alcohol treatment intervention will have improved adherence to HIV
antiretroviral therapy, improved CD4 cell counts, reduced HIV viral load, and reduced risky
sexual behavior, compared to women who receive similar assessments but no formal
intervention.
The investigators will recruit 90 women from 3 different sites in Florida, Washington DC and
Chicago. Of those 90 women 60 will receive naltrexone and 30 will receive placebo. Study
participants will take the medication for 4 months but the investigators will follow them for
7 months. At baseline, 2 months, 4 months and 7 months, the investigators will administer
study questionnaires and assess their liver enzymes, CD4 count and viral load. The
investigators will also follow them up at month 1 and 3 to reinforce the medication intake
and to assess for any possible side effects.
New treatment options are available, but their impact on hazardous drinking has not yet been
evaluated among HIV-infected women, many of whom are poor, minorities, or who have associated
mental health or substance abuse problems. Delivery of therapeutic interventions must be
improved in order to reduce hazardous drinking in women with HIV/AIDS. The proposed research
is significant because the therapy will be offered within HIV clinic settings and will
potentially improve the health of a population that is significantly undertreated. In
addition to determining the effectiveness of an alcohol treatment intervention, the
investigators will also identify key barriers and facilitators associated with adherence to
pharmacologic treatment for alcohol in women with hazardous drinking. The findings will
directly impact the type and quality of care for hazardous drinking in this subset of
HIV-infected individuals and will inform both primary and secondary prevention efforts
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