The efficacy of a brief intervention to reduce alcohol use in persons with HIV in South Africa, a randomized clinical trial
The efficacy of a brief intervention to reduce alcohol use in persons with HIV in South Africa, a randomized clinical trial
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DOI：
10.1371/journal.pone.0220799
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发表时间：
2019-08-20
期刊：
影响因子：
3.7
通讯作者：
Colebunders, Robert
中科院分区：
文献类型：
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作者：
in't Veld, Diana Huis;Ensoy-Musoro, Chellafe;Colebunders, Robert
背景由于非洲艾滋病毒患者高风险饮酒的比例很高，会对健康产生负面影响，因此需要采取短期干预措施来减少饮酒。方法我们基于信息-动机-行为技能模型，研究了旨在减少饮酒的短期干预措施对大量饮酒的艾滋病毒患者（通过审计衡量）的效果。该研究在南非的三个门诊诊所进行。干预组在一次干预中收到了针对审核结果的个性化反馈，试图让人们意识到他们属于中度或高风险饮酒类别。干预组和对照组均收到健康教育传单。结果共有560名患者参与研究，随访1年。两组的基线和随访点 1（5 个月）和 2（1 年）之间的 AUDIT 总分均显着下降。时间点 1 和 2 之间没有显着下降。然而，在干预组和对照组之间，随着时间的推移，饮酒量减少到戒酒或低风险饮酒没有差异，因为审计分数的绝对下降或审计分数变化的百分比没有差异。干预措施对两个时间点的生活质量、抑郁评分、耻辱感、烟草使用、病毒载量和治疗依从性没有影响。在所有次要结局中，干预与时间之间没有显着的交互作用。 结论 短期干预在干预后 5 个月和 12 个月均未能成功减少饮酒。然而，至少在短期随访期间，两个研究组对所报告的危险或有害酒精使用产生了有益的影响。也许只有访谈和/或分发健康传单才能成功减少饮酒，但这需要通过更客观的饮酒测量来进行调查。为了维持效果，很可能需要在长期随访期间与有害或有害的饮酒者重复接触。
BackgroundSince there is a high prevalence of high risk alcohol use in patients with HIV in Africa, with negative health effects, there is a need for short interventions to reduce alcohol use.MethodsWe studied the efficacy of a short intervention aiming to reduce alcohol use based on the Information-Motivation-Behavioural Skills Model in patients with HIV with high alcohol use (measured by AUDIT). The study was performed in three outpatient clinics in South Africa. The intervention group received in one-session intervention a personalized feedback on AUDIT results trying to make people aware that they are in the medium-or high-risk drinking category. Both the intervention and the control group received a health education leaflet.ResultsA total of 560 patients participated in the study with a follow up of 1 year. There was a significant decrease in total AUDIT scores between baseline and follow up points 1 (5 months) and 2 (1 year) in both groups. There was no significant decrease between time points 1 and 2. However, between the intervention and control groups there was no difference in reduction of alcohol use to abstinence or low risk alcohol use over time as there was no difference in absolute decrease in AUDIT-score or percentage of change in AUDIT score. The intervention had no influence on the quality of life outcomes, depression scores, stigma, tobacco use, viral load and therapy adherence at both time points. In all secondary outcomes, there was no significant interaction between intervention and time.ConclusionThe brief intervention was not successful at reducing alcohol use both 5 and 12 months after the intervention. However, there was a beneficial effect on reported hazardous or harmful alcohol use at least over a short term follow up period in both study groups. It might be that only an interview and/or the distribution of a health leaflet can be successful in reducing alcohol use but this needs to be investigated with more objective measures of alcohol use. To sustain an effect, most likely repetitive contacts with hazardous or harmful alcohol drinkers will be needed during a long follow up period.