Impact of alcohol-focused interventions on treatment outcomes amongst HIV patients in Tanzania and South Africa: A feasibility study

过度饮酒在东部和南部非洲很常见，包括在艾滋病毒感染者和使用抗逆转录病毒疗法的人群中。在艾滋病毒感染者中使用酒精与抗逆转录病毒药物使用不当以及错过护理和治疗规划有关。这表明，在艾滋病毒诊所实施减少酒精使用的策略可能会改善艾滋病患者的抗逆转录病毒药物使用和健康。我们的长期计划是在坦桑尼亚和南非进行一项试验，以帮助增加过度饮酒的艾滋病毒感染者使用抗逆转录病毒药物，目标是改善他们的健康状况。拟议的当前研究将收集准备未来主要试验所需的信息；即，提供以下方面的信息：(a)确定缺乏这方面信息的坦桑尼亚PLWH中过度饮酒的程度；(b)制定和调整减少过度饮酒的战略；(c)查明这些战略在坦桑尼亚和南非是否可行和可接受。我们将收集坦桑尼亚300名使用抗逆转录病毒药物的患者中酒精使用程度的信息。然后，我们将审查已发表的关于减少过度饮酒战略的信息，从每个国家四家艾滋病毒诊所的40名卫生工作者（HWs）那里获得调查数据，并与主要利益攸关方（包括卫生工作者、卫生部官员、治疗支持者）和艾滋病毒患者进行深入访谈。将在一个讲习班上审查取得的成果，以制定减少过度饮酒的最终战略。最后，评估策略的可行性和可接受性。

Excessive use of alcohol is common in eastern and southern Africa, including among those people living with HIV (PLWH) and using antiretroviral therapy (ART). Using alcohol among PLWH is associated with poor usage of ART drugs and being lost to care and treatment programmes. This suggests that strategies that reduce alcohol use when implemented at HIV clinics may improve PLWH's ART drug usage and health. Our long-term plan is to conduct a trial to help increase ART usage among PLWH who use alcohol excessively with a goal of improving their health in Tanzania and South Africa. The proposed current study will collect information required for preparing the future main trial; namely, information to (a) determine the extent of excessive alcohol use among PLWH in Tanzania where this information is lacking, (b) develop and adapt strategies to reduce excessive alcohol use, and (c) find out if the strategies are feasible and acceptable in Tanzania and South Africa.We will collect information about the extent of alcohol use among 300 patients using ART drugs in Tanzania. We will then review published information on strategies to reduce excessive alcohol use, obtain survey data from 40 health workers (HWs) at four HIV clinics in each country, and conduct in-depth interviews (IDIs) with key stakeholders (including HWs, ministry of health officials, treatment supporters) and HIV patients. Results obtained will be reviewed at a workshop to develop a final strategy for reducing excessive alcohol use. Finally, the feasibility and acceptability of the strategy will be assessed.