Reducing Unsafe Alcohol Use in HIV-Positive Individuals

• Alcohol Consumption
  

• HIV Medication adherence
  
• HIV risk behavior
  
• HIV viral load (CD4 count)
  
• Liver enzymes/liver status (ALT, AST)
  
• Liver diseases (ALT, AST control variables)
  
• Depression (BDI score)
  
• Drug use
  
• Alcohol dependence
  
• Start of alcohol treatment/AA
  
• Start of hepatitis treatment if infected
  

HIV infection is a widespread health problem in the U.S. Antiretroviral treatment has increased longevity and changed the nature of risk factors for morbidity and mortality. Alcohol consumption has become an increasingly serious health issue among HIV primary care patients. Drinking is a key factor in progression to severe liver damage (especially those co-infected with hepatitis), and liver disease is now one of the most common causes of death among those with HIV. Excess drinking is also associated with medication noncompliance, reduces the effect of antiretroviral treatment, and is linked to other health problems. Therefore, helping HIV patients reduce unsafe drinking is crucial to their long-term health. The intervention combines the brief MI, an established, evidence-based counseling approach, with an innovative procedure designed to strengthen the effects of the MI. An effective, easily implemented alcohol-reduction intervention could be incorporated into standard care in HIV clinics helping prevent or slow the progress of some medical problems in HIV-infected individuals, improve medication compliance, prolong lifespan and decrease risk behavior associated with alcohol use.

Comparison(s): Enhanced brief motivational interview (including an IVR component for alcohol self-monitoring purposes), brief motivational interview, viewing a DVD on HIV self-care.