A randomized clinical trial of a group cognitive-behavioral therapy to reduce alcohol use among human immunodeficiency virus-infected outpatients in western Kenya.
A randomized clinical trial of a group cognitive-behavioral therapy to reduce alcohol use among human immunodeficiency virus-infected outpatients in western Kenya.
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肯尼亚西部人类免疫缺陷病毒感染门诊患者采用集体认知行为疗法减少饮酒的随机临床试验
DOI：
10.1111/add.15112
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Maisto SA
中科院分区：
文献类型：
--
作者：
Papas RK;Gakinya BN;Mwaniki MM;Lee H;Keter AK;Martino S;Klein DA;Liu T;Loxley MP;Sidle JE;Schlaudt K;Nafula T;Omodi VM;Baliddawa JB;Kinyanjui DW;Maisto SA
需要采取文化上相关和可行的干预措施，以解决撒哈拉以南非洲在从行为上治疗艾滋病毒和酒精使用障碍双重流行病方面专业资源有限的问题。这项研究测试了认知行为治疗（CBT）干预措施在减少肯尼亚埃尔多雷特艾滋病毒感染门诊患者饮酒方面的有效性。随机临床试验。肯尼亚埃尔多雷特的一家大型艾滋病毒门诊诊所，隶属于提供医疗保健机会的学术模式合作组织。共有614例HIV感染门诊患者（312例CBT; 302例HL; 48.5%男性;平均年龄：38.9岁;平均教育7.7年）报告了最低限度的危险或酗酒。一项文化适应的6次性别分层小组CBT干预与健康生活方式教育（HL）进行比较，每一次都由专业人员提供，每周6次，每次90分钟，随访9个月。主要结果测量为饮酒天数百分比（PDD）和每日平均饮酒量（DDD），通过使用时间轴随访从基线至干预后9个月获得的回顾性每日饮酒量数据计算。探索性分析检查了无保护的性行为和伴侣数量。所有条件下的中位出席率为6次会议。9个月随访时保持率为85%。在所有三个研究阶段，CBT的PDD和DDD边缘均值均显著低于HL。维护周期：PDD-CBT 3.64（0.70），HL 5.72（0.71），平均差异2.08（95% CI 0.13-4.04）; DDD-CBT 0.66（0.10）HL 0.98（0.10），平均差异0.31（95% CI 0.05-0.58）。在这两种情况下，风险性行为随着时间的推移而减少，在1个月的随访中对CBT有暂时的影响。认知行为治疗干预比健康生活方式教育更有效地减少艾滋病毒感染的肯尼亚门诊饮酒者的饮酒。
Culturally relevant and feasible interventions are needed to address limited professional resources in sub-Saharan Africa for behaviorally treating the dual epidemics of HIV and alcohol use disorder. This study tested the efficacy of a cognitive-behavioral therapy (CBT) intervention to reduce alcohol use among HIV-infected outpatients in Eldoret, Kenya. Randomized clinical trial. A large HIV outpatient clinic in Eldoret, Kenya, affiliated with the Academic Model Providing Access to Healthcare collaboration. A total of 614 HIV-infected outpatients (312 CBT; 302 HL; 48.5% male; mean age: 38.9 years; mean education 7.7 years) who reported a minimum of hazardous or binge drinking. A culturally adapted 6-session gender-stratified group CBT intervention compared with Healthy Lifestyles education (HL), each delivered by paraprofessionals over 6 weekly 90-minute sessions with a 9-month follow-up. Primary outcome measures were percent drinking days (PDD) and mean drinks per drinking day (DDD) computed from retrospective daily number of drinks data obtained by use of the Timeline Followback from baseline through 9-months post-intervention. Exploratory analyses examined unprotected sex and number of partners. Median attendance was 6 sessions across condition. Retention was 85% through the 9-month follow-up. PDD and DDD marginal means were significantly lower in CBT than HL at all three study phases. Maintenance period: PDD–CBT 3.64 (0.70), HL 5.72 (0.71), mean difference 2.08 (95% CI 0.13-4.04); DDD–CBT 0.66 (0.10) HL 0.98 (0.10), mean difference 0.31 (95% CI 0.05-0.58). Risky sex decreased over time in both conditions, with a temporary effect for CBT at the 1-month follow-up. A cognitive-behavioral therapy intervention was more efficacious than Healthy Lifestyles education in reducing alcohol use among HIV-infected Kenyan outpatient drinkers.
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DOI：
10.1111/acer.12332
发表时间：
2014-04
期刊：
Alcoholism, clinical and experimental research
影响因子：
--
作者：
Braithwaite RS;Nucifora KA;Kessler J;Toohey C;Mentor SM;Uhler LM;Roberts MS;Bryant K
通讯作者：
Bryant K
影响因子：
7.4
作者：
Einterz, Robert M.;Kimaiyo, Sylvester;Mamlin, Joseph J.
通讯作者：
Mamlin, Joseph J.
影响因子：
4.2
作者：
Carroll, KM;Nich, C;Rounsaville, BJ
通讯作者：
Rounsaville, BJ
影响因子：
5.9
作者：
Connors, GJ;Walitzer, KS
通讯作者：
Walitzer, KS
影响因子：
3.6
作者：
Feldblum, PJ;Kuyoh, M;Welsh, M
通讯作者：
Welsh, M