Brief Intervention Decreases Drinking Frequency in HIV-Infected, Heavy Drinking Women: Results of a Randomized Controlled Trial.
Brief Intervention Decreases Drinking Frequency in HIV-Infected, Heavy Drinking Women: Results of a Randomized Controlled Trial.
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DOI：
10.1097/qai.0000000000000679
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发表时间：
2015-10-01
期刊：
影响因子：
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通讯作者：
McCaul ME
中科院分区：
文献类型：
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作者：
Chander G;Hutton HE;Lau B;Xu X;McCaul ME
HIV感染妇女危险饮酒与不良HIV结果和HIV传播风险行为相关。我们研究了短暂的酒精干预（BI）的有效性危险饮酒妇女在城市，艾滋病诊所接受治疗。女性被随机分配至2个疗程的BI或常规护理。基线、3、6和12个月时评估的结局包括90天内任何饮酒和重度/暴饮（每次饮酒≥4杯）的频率，以及每次饮酒事件的平均饮酒量。次要结局包括HIV药物治疗和预约依从性、HIV 1-RNA抑制和无保护阴道性行为天数。我们使用广义混合效应模型和分位数回归检验了干预的有效性。在混合效应模型中，干预组与对照组相比，90天饮酒频率降低，干预条件下的妇女不太可能有饮酒日（OR：0.42（95%CI：0.23-0.75）。重度/暴饮日和每饮酒日的饮酒量在两组之间没有显著差异。分位数回归表明，在中间到上部范围的饮酒日和重度/狂欢饮酒日，干预和控制条件之间的差异显着的分布饮酒频率下降。在随访中，干预组的无保护阴道性交次数明显减少。未观察到其他结局的干预效应。短暂的酒精干预减少了艾滋病毒感染妇女的饮酒频率和无保护阴道性交。可能需要更密集的服务，以减少每天饮酒量，并加强对受影响更严重的饮酒者的护理。
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.