Systematic cultural adaptation of cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in western Kenya
Identifieur interne : 002421 ( Pmc/Checkpoint ); précédent : 002420; suivant : 002422Systematic cultural adaptation of cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in western Kenya
Auteurs : Rebecca K. Papas ; John E. Sidle ; Steve Martino ; Joyce B. Baliddawa ; Rogers Songole ; Otieno E. Omolo ; Benson N. Gakinya ; Michael M. Mwaniki ; Japheth O. Adina ; Tobista Nafula ; Willis D. Owino-Ong R ; Kendall J. Bryant ; Kathleen M. Carroll ; Joseph L. Goulet ; Amy C. Justice ; Stephen A. MaistoSource :
- AIDS and behavior [ 1090-7165 ] ; 2010.
Abstract
Two-thirds of those with HIV worldwide live in sub-Saharan Africa. Alcohol use is associated with the HIV epidemic through risky sex and suboptimal ARV adherence. In western Kenya, hazardous drinking was reported by HIV (53%) and general medicine (68%) outpatients. Cognitive behavioral treatment (CBT) has demonstrated strong efficacy to reduce alcohol use. This article reports on a systematic cultural adaptation and pilot feasibility study of group paraprofessional-delivered CBT to reduce alcohol use among HIV-infected outpatients in Eldoret, Kenya. Following adaptation and counselor training, five pilot groups were run (n=27). Overall attendance was 77%. Percent days abstinent from alcohol (PDA) before session 1 was 52%–100% (women) and 21–36% (men), and by session 6 was 96%–100% (women) and 89%–100% (men). PDA effect sizes (Cohen’s d) between first and last CBT session were 2.32 (women) and 2.64 (men). Participants reported treatment satisfaction. Results indicate feasibility, acceptability and preliminary efficacy for CBT in Kenya.
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DOI: 10.1007/s10461-009-9647-6
PubMed: 19967441
PubMed Central: 2949418
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<front><div type="abstract" xml:lang="en"><p id="P1">Two-thirds of those with HIV worldwide live in sub-Saharan Africa. Alcohol use is associated with the HIV epidemic through risky sex and suboptimal ARV adherence. In western Kenya, hazardous drinking was reported by HIV (53%) and general medicine (68%) outpatients. Cognitive behavioral treatment (CBT) has demonstrated strong efficacy to reduce alcohol use. This article reports on a systematic cultural adaptation and pilot feasibility study of group paraprofessional-delivered CBT to reduce alcohol use among HIV-infected outpatients in Eldoret, Kenya. Following adaptation and counselor training, five pilot groups were run (n=27). Overall attendance was 77%. Percent days abstinent from alcohol (PDA) before session 1 was 52%–100% (women) and 21–36% (men), and by session 6 was 96%–100% (women) and 89%–100% (men). PDA effect sizes (Cohen’s d) between first and last CBT session were 2.32 (women) and 2.64 (men). Participants reported treatment satisfaction. Results indicate feasibility, acceptability and preliminary efficacy for CBT in Kenya.</p>
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<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9712133</journal-id>
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<journal-id journal-id-type="nlm-ta">AIDS Behav</journal-id>
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<title-group><article-title>Systematic cultural adaptation of cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in western Kenya</article-title>
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<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Papas</surname>
<given-names>Rebecca K.</given-names>
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<email>Rebecca_papas@brown.edu</email>
<aff id="A1">Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, USA</aff>
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<contrib contrib-type="author"><name><surname>Sidle</surname>
<given-names>John E.</given-names>
</name>
<aff id="A2">Moi University School of Medicine, Department of Medicine, Eldoret, Kenya</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Martino</surname>
<given-names>Steve</given-names>
</name>
<aff id="A3">Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA</aff>
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<contrib contrib-type="author"><name><surname>Baliddawa</surname>
<given-names>Joyce B.</given-names>
</name>
<aff id="A4">Moi University School of Medicine, Department of Behavioral Sciences, Eldoret, Kenya</aff>
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<contrib contrib-type="author"><name><surname>Songole</surname>
<given-names>Rogers</given-names>
</name>
<aff id="A5">Moi University School of Medicine, Department of Mental Health Services, Eldoret, Kenya</aff>
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<contrib contrib-type="author"><name><surname>Omolo</surname>
<given-names>Otieno E.</given-names>
</name>
<aff id="A6">Moi University School of Medicine, Department of Mental Health Services, Eldoret, Kenya</aff>
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<contrib contrib-type="author"><name><surname>Gakinya</surname>
<given-names>Benson N.</given-names>
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<aff id="A7">Moi University School of Medicine, Department of Mental Health Services, Eldoret, Kenya</aff>
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<contrib contrib-type="author"><name><surname>Mwaniki</surname>
<given-names>Michael M.</given-names>
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<aff id="A8">Kenya Health Behavior Study, Eldoret, Kenya</aff>
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<contrib contrib-type="author"><name><surname>Adina</surname>
<given-names>Japheth O.</given-names>
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<aff id="A9">Kenya Health Behavior Study, Eldoret, Kenya</aff>
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<contrib contrib-type="author"><name><surname>Nafula</surname>
<given-names>Tobista</given-names>
</name>
<aff id="A10">Kenya Health Behavior Study, Eldoret, Kenya</aff>
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<contrib contrib-type="author"><name><surname>Owino-Ong’or</surname>
<given-names>Willis D.</given-names>
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<aff id="A11">Moi University School of Medicine, Department of Medicine, Eldoret, Kenya</aff>
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<contrib contrib-type="author"><name><surname>Bryant</surname>
<given-names>Kendall J.</given-names>
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<aff id="A12">National Institute of Alcohol Abuse and Alcoholism, Rockville, MD</aff>
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<contrib contrib-type="author"><name><surname>Carroll</surname>
<given-names>Kathleen M.</given-names>
</name>
<aff id="A13">Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Goulet</surname>
<given-names>Joseph L.</given-names>
</name>
<aff id="A14">Yale University School of Medicine, Department of Medicine, New Haven, CT, USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Justice</surname>
<given-names>Amy C.</given-names>
</name>
<aff id="A15">Yale University School of Medicine, Department of Medicine, New Haven, CT, USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Maisto</surname>
<given-names>Stephen A.</given-names>
</name>
<aff id="A16">Syracuse University, Department of Psychology, Syracuse, NY, USA</aff>
</contrib>
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<pub-date pub-type="nihms-submitted"><day>17</day>
<month>9</month>
<year>2010</year>
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<pub-date pub-type="ppub"><month>6</month>
<year>2010</year>
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<pub-date pub-type="pmc-release"><day>1</day>
<month>6</month>
<year>2011</year>
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<volume>14</volume>
<issue>3</issue>
<fpage>669</fpage>
<lpage>678</lpage>
<abstract><p id="P1">Two-thirds of those with HIV worldwide live in sub-Saharan Africa. Alcohol use is associated with the HIV epidemic through risky sex and suboptimal ARV adherence. In western Kenya, hazardous drinking was reported by HIV (53%) and general medicine (68%) outpatients. Cognitive behavioral treatment (CBT) has demonstrated strong efficacy to reduce alcohol use. This article reports on a systematic cultural adaptation and pilot feasibility study of group paraprofessional-delivered CBT to reduce alcohol use among HIV-infected outpatients in Eldoret, Kenya. Following adaptation and counselor training, five pilot groups were run (n=27). Overall attendance was 77%. Percent days abstinent from alcohol (PDA) before session 1 was 52%–100% (women) and 21–36% (men), and by session 6 was 96%–100% (women) and 89%–100% (men). PDA effect sizes (Cohen’s d) between first and last CBT session were 2.32 (women) and 2.64 (men). Participants reported treatment satisfaction. Results indicate feasibility, acceptability and preliminary efficacy for CBT in Kenya.</p>
</abstract>
<kwd-group><kwd>alcohol</kwd>
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<contract-sponsor id="DA1">National Institute on Drug Abuse : NIDA</contract-sponsor>
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<name sortKey="Bryant, Kendall J" sort="Bryant, Kendall J" uniqKey="Bryant K" first="Kendall J." last="Bryant">Kendall J. Bryant</name>
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<name sortKey="Gakinya, Benson N" sort="Gakinya, Benson N" uniqKey="Gakinya B" first="Benson N." last="Gakinya">Benson N. Gakinya</name>
<name sortKey="Goulet, Joseph L" sort="Goulet, Joseph L" uniqKey="Goulet J" first="Joseph L." last="Goulet">Joseph L. Goulet</name>
<name sortKey="Justice, Amy C" sort="Justice, Amy C" uniqKey="Justice A" first="Amy C." last="Justice">Amy C. Justice</name>
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<name sortKey="Omolo, Otieno E" sort="Omolo, Otieno E" uniqKey="Omolo O" first="Otieno E." last="Omolo">Otieno E. Omolo</name>
<name sortKey="Owino Ong R, Willis D" sort="Owino Ong R, Willis D" uniqKey="Owino Ong R W" first="Willis D." last="Owino-Ong R">Willis D. Owino-Ong R</name>
<name sortKey="Papas, Rebecca K" sort="Papas, Rebecca K" uniqKey="Papas R" first="Rebecca K." last="Papas">Rebecca K. Papas</name>
<name sortKey="Sidle, John E" sort="Sidle, John E" uniqKey="Sidle J" first="John E." last="Sidle">John E. Sidle</name>
<name sortKey="Songole, Rogers" sort="Songole, Rogers" uniqKey="Songole R" first="Rogers" last="Songole">Rogers Songole</name>
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