Brief Intervention Decreases Drinking Frequency in HIV-Infected, Heavy Drinking Women: Results of a Randomized Controlled Trial
Identifieur interne : 001940 ( Pmc/Corpus ); précédent : 001939; suivant : 001941Brief Intervention Decreases Drinking Frequency in HIV-Infected, Heavy Drinking Women: Results of a Randomized Controlled Trial
Auteurs : Geetanjali Chander ; Heidi E. Hutton ; Bryan Lau ; Xiaoqiang Xu ; Mary E. MccaulSource :
- Journal of acquired immune deficiency syndromes (1999) [ 1525-4135 ] ; 2015.
Abstract
Hazardous alcohol use by HIV-infected women is associated with poor HIV outcomes and HIV transmission risk behaviors. We examined the effectiveness of brief alcohol intervention (BI) among hazardous drinking women receiving care in an urban, HIV clinic.
Women were randomized to a 2-session BI or usual care. Outcomes assessed at baseline, 3, 6 and 12 months included 90-day frequency of any alcohol use and heavy/binge drinking (≥4 drinks per occasion), and average drinks per drinking episode. Secondary outcomes included HIV medication and appointment adherence, HIV1-RNA suppression, and days of unprotected vaginal sex. We examined intervention effectiveness using generalized mixed effect models and quantile regression.
Of 148 eligible women, 74 were randomized to each arm. In mixed effects models, 90-day drinking frequency decreased among intervention group compared to control, with women in the intervention condition less likely to have a drinking day (OR: 0.42 (95% CI: 0.23–0.75). Heavy/binge drinking days and drinks per drinking day did not differ significantly between groups. Quantile regression demonstrated a decrease in drinking frequency in the middle to upper ranges of the distribution of drinking days and heavy/binge drinking days that differed significantly between intervention and control conditions. At follow-up, the intervention group had significantly fewer episodes of unprotected vaginal sex. No intervention effects were observed for other outcomes.
Brief alcohol intervention reduces frequency of alcohol use and unprotected vaginal sex among HIV-infected women. More intensive services may be needed to lower drinks per drinking day and enhance care for more severely affected drinkers.
Url:
DOI: 10.1097/QAI.0000000000000679
PubMed: 25967270
PubMed Central: 4634011
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PMC:4634011Le document en format XML
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<author><name sortKey="Chander, Geetanjali" sort="Chander, Geetanjali" uniqKey="Chander G" first="Geetanjali" last="Chander">Geetanjali Chander</name>
<affiliation><nlm:aff id="A1">Department of Medicine, The Johns Hopkins University School of Medicine</nlm:aff>
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<author><name sortKey="Hutton, Heidi E" sort="Hutton, Heidi E" uniqKey="Hutton H" first="Heidi E." last="Hutton">Heidi E. Hutton</name>
<affiliation><nlm:aff id="A2">Department of Psychiatry & Behavioral Sciences, The Johns Hopkins University School of Medicine</nlm:aff>
</affiliation>
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<author><name sortKey="Lau, Bryan" sort="Lau, Bryan" uniqKey="Lau B" first="Bryan" last="Lau">Bryan Lau</name>
<affiliation><nlm:aff id="A1">Department of Medicine, The Johns Hopkins University School of Medicine</nlm:aff>
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<affiliation><nlm:aff id="A3">Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health</nlm:aff>
</affiliation>
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<author><name sortKey="Xu, Xiaoqiang" sort="Xu, Xiaoqiang" uniqKey="Xu X" first="Xiaoqiang" last="Xu">Xiaoqiang Xu</name>
<affiliation><nlm:aff id="A2">Department of Psychiatry & Behavioral Sciences, The Johns Hopkins University School of Medicine</nlm:aff>
</affiliation>
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<author><name sortKey="Mccaul, Mary E" sort="Mccaul, Mary E" uniqKey="Mccaul M" first="Mary E." last="Mccaul">Mary E. Mccaul</name>
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<affiliation><nlm:aff id="A1">Department of Medicine, The Johns Hopkins University School of Medicine</nlm:aff>
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<author><name sortKey="Hutton, Heidi E" sort="Hutton, Heidi E" uniqKey="Hutton H" first="Heidi E." last="Hutton">Heidi E. Hutton</name>
<affiliation><nlm:aff id="A2">Department of Psychiatry & Behavioral Sciences, The Johns Hopkins University School of Medicine</nlm:aff>
</affiliation>
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<author><name sortKey="Lau, Bryan" sort="Lau, Bryan" uniqKey="Lau B" first="Bryan" last="Lau">Bryan Lau</name>
<affiliation><nlm:aff id="A1">Department of Medicine, The Johns Hopkins University School of Medicine</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3">Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health</nlm:aff>
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<author><name sortKey="Xu, Xiaoqiang" sort="Xu, Xiaoqiang" uniqKey="Xu X" first="Xiaoqiang" last="Xu">Xiaoqiang Xu</name>
<affiliation><nlm:aff id="A2">Department of Psychiatry & Behavioral Sciences, The Johns Hopkins University School of Medicine</nlm:aff>
</affiliation>
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<author><name sortKey="Mccaul, Mary E" sort="Mccaul, Mary E" uniqKey="Mccaul M" first="Mary E." last="Mccaul">Mary E. Mccaul</name>
<affiliation><nlm:aff id="A2">Department of Psychiatry & Behavioral Sciences, The Johns Hopkins University School of Medicine</nlm:aff>
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<series><title level="j">Journal of acquired immune deficiency syndromes (1999)</title>
<idno type="ISSN">1525-4135</idno>
<idno type="eISSN">1944-7884</idno>
<imprint><date when="2015">2015</date>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title>
<p id="P1">Hazardous alcohol use by HIV-infected women is associated with poor HIV outcomes and HIV transmission risk behaviors. We examined the effectiveness of brief alcohol intervention (BI) among hazardous drinking women receiving care in an urban, HIV clinic.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Women were randomized to a 2-session BI or usual care. Outcomes assessed at baseline, 3, 6 and 12 months included 90-day frequency of any alcohol use and heavy/binge drinking (≥4 drinks per occasion), and average drinks per drinking episode. Secondary outcomes included HIV medication and appointment adherence, HIV1-RNA suppression, and days of unprotected vaginal sex. We examined intervention effectiveness using generalized mixed effect models and quantile regression.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Of 148 eligible women, 74 were randomized to each arm. In mixed effects models, 90-day drinking frequency decreased among intervention group compared to control, with women in the intervention condition less likely to have a drinking day (OR: 0.42 (95% CI: 0.23–0.75). Heavy/binge drinking days and drinks per drinking day did not differ significantly between groups. Quantile regression demonstrated a decrease in drinking frequency in the middle to upper ranges of the distribution of drinking days and heavy/binge drinking days that differed significantly between intervention and control conditions. At follow-up, the intervention group had significantly fewer episodes of unprotected vaginal sex. No intervention effects were observed for other outcomes.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Brief alcohol intervention reduces frequency of alcohol use and unprotected vaginal sex among HIV-infected women. More intensive services may be needed to lower drinks per drinking day and enhance care for more severely affected drinkers.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">100892005</journal-id>
<journal-id journal-id-type="pubmed-jr-id">21821</journal-id>
<journal-id journal-id-type="nlm-ta">J Acquir Immune Defic Syndr</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Acquir. Immune Defic. Syndr.</journal-id>
<journal-title-group><journal-title>Journal of acquired immune deficiency syndromes (1999)</journal-title>
</journal-title-group>
<issn pub-type="ppub">1525-4135</issn>
<issn pub-type="epub">1944-7884</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25967270</article-id>
<article-id pub-id-type="pmc">4634011</article-id>
<article-id pub-id-type="doi">10.1097/QAI.0000000000000679</article-id>
<article-id pub-id-type="manuscript">NIHMS686754</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Brief Intervention Decreases Drinking Frequency in HIV-Infected, Heavy Drinking Women: Results of a Randomized Controlled Trial</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Chander</surname>
<given-names>Geetanjali</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hutton</surname>
<given-names>Heidi E.</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lau</surname>
<given-names>Bryan</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Xu</surname>
<given-names>Xiaoqiang</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>McCaul</surname>
<given-names>Mary E.</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Department of Medicine, The Johns Hopkins University School of Medicine</aff>
<aff id="A2"><label>2</label>
Department of Psychiatry & Behavioral Sciences, The Johns Hopkins University School of Medicine</aff>
<aff id="A3"><label>3</label>
Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health</aff>
<author-notes><corresp id="FN1">Corresponding Author: Geetanjali Chander, M.D., 1830 E. Monument Street, 8047, Baltimore, MD 21287, <email>Gchande1@jhmi.edu</email>
, Fax: 410-955-4634</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>6</day>
<month>6</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub"><day>1</day>
<month>10</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>10</month>
<year>2016</year>
</pub-date>
<volume>70</volume>
<issue>2</issue>
<fpage>137</fpage>
<lpage>145</lpage>
<pmc-comment>elocation-id from pubmed: 10.1097/QAI.0000000000000679</pmc-comment>
<abstract><sec id="S1"><title>Objective</title>
<p id="P1">Hazardous alcohol use by HIV-infected women is associated with poor HIV outcomes and HIV transmission risk behaviors. We examined the effectiveness of brief alcohol intervention (BI) among hazardous drinking women receiving care in an urban, HIV clinic.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Women were randomized to a 2-session BI or usual care. Outcomes assessed at baseline, 3, 6 and 12 months included 90-day frequency of any alcohol use and heavy/binge drinking (≥4 drinks per occasion), and average drinks per drinking episode. Secondary outcomes included HIV medication and appointment adherence, HIV1-RNA suppression, and days of unprotected vaginal sex. We examined intervention effectiveness using generalized mixed effect models and quantile regression.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Of 148 eligible women, 74 were randomized to each arm. In mixed effects models, 90-day drinking frequency decreased among intervention group compared to control, with women in the intervention condition less likely to have a drinking day (OR: 0.42 (95% CI: 0.23–0.75). Heavy/binge drinking days and drinks per drinking day did not differ significantly between groups. Quantile regression demonstrated a decrease in drinking frequency in the middle to upper ranges of the distribution of drinking days and heavy/binge drinking days that differed significantly between intervention and control conditions. At follow-up, the intervention group had significantly fewer episodes of unprotected vaginal sex. No intervention effects were observed for other outcomes.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Brief alcohol intervention reduces frequency of alcohol use and unprotected vaginal sex among HIV-infected women. More intensive services may be needed to lower drinks per drinking day and enhance care for more severely affected drinkers.</p>
</sec>
</abstract>
<kwd-group><kwd>Brief Alcohol Intervention</kwd>
<kwd>Women</kwd>
<kwd>HIV</kwd>
<kwd>Alcohol</kwd>
<kwd>Randomized Controlled Trial</kwd>
</kwd-group>
</article-meta>
</front>
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