HIV Clinical Trial
Official title:
Reducing Hazardous Alcohol Use & Human Immunodeficiency Virus (HIV) Viral Load: A Randomized Controlled Trial (RCT) in Antiretroviral Therapy (ART) Clinics in Vietnam
The purpose of this study is to compare the effectiveness of two interventions [a Brief Intervention (BI) and a Motivational Enhancement Therapy+Cognitive Behavioral Therapy (MET+CBT) Intervention], against each other and with an assessment-only control, in improving both alcohol- and HIV-related outcomes, among hazardous and heavy drinking HIV-infected antiretroviral therapy (ART) clinic clients in Thai Nguyen, Vietnam.
This study is a three-arm randomized controlled trial among hazardous and heavy drinking
HIV-infected ART clinic clients in Thai Nguyen province, Vietnam. It compares the effects of
two evidence-based, culturally adapted, behavioral interventions [a Brief Intervention (BI)
and a Motivational Enhancement Therapy+Cognitive Behavioral Therapy (MET+CBT) Intervention]
both against each other and compared with an assessment-only standard of care arm, in order
to understand the relative effectiveness of each intervention in reducing alcohol use and
suppressing HIV viral load.
The Brief Intervention (BI) consists of 2 individual sessions and 2 booster phone sessions
delivered by a trained counselor and is based on Project Treat. Content of BI sessions
includes review of drinking patterns, harmful effects of drinking, and alcohol use behavior
change strategies. The MET+CBT Intervention consists of 6 sessions delivered by a trained
counselor. The MET+CBT Intervention uses a client-centered, motivational interviewing
approach and focuses on skills-building for alcohol use behavior change, including drinking
refusal skills, skills to cope with and manage cravings and triggers, and developing positive
thoughts and attitudes. It also includes review of drinking patterns and harmful effects of
drinking.
This study will also measure the incremental cost-effectiveness of each intervention as
compared to current counseling services offered in ART clinics in Vietnam.
Investigators hypothesize that: 1) Each intervention will be more effective than an
assessment-only arm on percent days alcohol abstinent and percent virally suppressed at the
12-month assessment; 2) The BI will be equivalently effective to the MET+CBT Intervention on
percent days alcohol abstinent; 3) The effect of each intervention on alcohol abstinence and
viral suppression will be mediated by alcohol use readiness to change and/or coping skills
acquisition; 4) The MET+CBT Intervention will be more effective than the BI on alcohol
abstinence and viral suppression separately among participants with more severe alcohol use,
people who inject drugs, and participants with depressive symptoms; 5) The alcohol reduction
interventions (BI and MET+CBT Intervention) will be highly cost-effective compared to
assessment-only standard of care; and 6) The BI will be highly cost-effective relative to the
MET+CBT Intervention.
Understanding the relative effectiveness of each intervention in improving both alcohol- and
HIV-related outcomes will provide insight into the optimal application of alcohol programs in
resource-limited settings.
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