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01-06-2010 | Original Paper

Systematic Cultural Adaptation of Cognitive-Behavioral Therapy to Reduce Alcohol Use Among HIV-Infected Outpatients in Western Kenya

Authors: Rebecca K. Papas, John E. Sidle, Steve Martino, Joyce B. Baliddawa, Rogers Songole, Otieno E. Omolo, Benson N. Gakinya, Michael M. Mwaniki, Japheth O. Adina, Tobista Nafula, Willis D. Owino-Ong’or, Kendall J. Bryant, Kathleen M. Carroll, Joseph L. Goulet, Amy C. Justice, Stephen A. Maisto

Published in: AIDS and Behavior | Issue 3/2010

Abstract

Two-thirds of those with HIV worldwide live in sub-Saharan Africa. Alcohol use is associated with the HIV epidemic through risky sex and suboptimal ARV adherence. In western Kenya, hazardous drinking was reported by HIV (53%) and general medicine (68%) outpatients. Cognitive behavioral treatment (CBT) has demonstrated strong efficacy to reduce alcohol use. This article reports on a systematic cultural adaptation and pilot feasibility study of group paraprofessional-delivered CBT to reduce alcohol use among HIV-infected outpatients in Eldoret, Kenya. Following adaptation and counselor training, five pilot groups were run (n = 27). Overall attendance was 77%. Percent days abstinent from alcohol (PDA) before session 1 was 52–100% (women) and 21–36% (men), and by session 6 was 96–100% (women) and 89–100% (men). PDA effect sizes (Cohen’s d) between first and last CBT session were 2.32 (women) and 2.64 (men). Participants reported treatment satisfaction. Results indicate feasibility, acceptability and preliminary efficacy for CBT in Kenya.

UNAIDS/WHO. AIDS epidemic update: December 2007. Geneva/UNAIDS/WHO. Ref Type: Report.

Ayisi JG, van Eijk AM, ter Kuil OF, et al. Risk factors for HIV infection among asymptomatic pregnant women attending an antenatal clinic in western Kenya. Int J STD AIDS. 2000;11:393–401.CrossRefPubMed

Seage GR III, Holte S, Gross M, et al. Case-crossover study of partner and situational factors for unprotected sex. J Acquir Immune Defic Syndr. 2002;31:432–9.PubMed

Braithwaite RS, McGinnis KA, Conigliaro J, et al. A temporal and dose-response association between alcohol consumption and medication adherence among veterans in care. Alcohol Clin Exp Res. 2005;29:1190–7.CrossRefPubMed

Justice AC, Lasky E, McGinnis KA, et al. Comorbid disease and alcohol use among veterans with HIV infection: a comparison of measurement strategies. Med Care. 2006;44(Suppl 2):S52–60.CrossRefPubMed

Othieno CJ, Kathuku DM, Ndetei DM. Substance abuse in outpatients attending rural and urban health centres in Kenya. East Afr Med J. 2000;77:592–5.PubMed

Saunders JB, Aasland OG, Amundsen A, Grant M. Alcohol consumption and related problems among primary health care patients: WHO collaborative project on early detection of persons with harmful alcohol consumption-I. Addiction. 1993;88:349–62.CrossRefPubMed

World Health Organization. Global Status Report on Alcohol 2004. Geneva, WHO. Ref Type: Report.

Papas RK, Sidle JE, Wamalwa ES, et al. Estimating alcohol content of traditional brew in western Kenya using culturally relevant methods: the case for cost over volume. AIDS Behav. 2009 (in press).

10.

Shaffer DN, Njeri R, Justice AC, Odero WW, Tierney WM. Alcohol abuse among patients with and without HIV infection attending public clinics in western Kenya. East Afr Med J. 2004;81:594–8.PubMed

11.

Kalichman SC, Simbayi LC, Vermaak R, et al. Randomized trial of a community-based alcohol-related HIV risk-reduction intervention for men and women in Cape Town South Africa. Ann Behav Med. 2009 (in press).

12.

Chesney MA, Donnell D, Seage GR, Bryant KL. Project EXPLORE: impact of alcohol use on HIV sero-incidence among high-risk MSM in a large-scale prospective prevention intervention. Alcohol Clin Exp Res. 2009;33(Suppl 1). Ref Type: Abstract.

13.

Bandura A. Principles of behavior modification. New York: Holt, Rinehart & Winston; 1969.

14.

Monti PM, Kadden RM, Rohsenow DJ, Cooney NL, Abrams DB. Treating alcohol dependence: a coping skills training guide. 2nd ed. New York: The Guilford Press; 2002.

15.

Kadden RM, Cooney NL, Getter H, Litt MD. Matching alcoholics to coping skills or interactional therapy: posttreatment results. J Consult Clin Psychol. 1989;57:698–704.CrossRefPubMed

16.

Miller WR, Zweben J, Johnson WR. Evidence-based treatment: why, what, where, when and how? J Subst Abuse Treat. 2005;29:267–76.CrossRefPubMed

17.

Project Match Research Group. Matching alcoholism treatments to client heterogeneity: project MATCH posttreatment drinking outcomes. J Stud Alcohol. 1997;58:7–29.

18.

Jones DL, Ross D, Weiss SM, Bhat G, Chitalu N. Influence of partner participation on sexual risk behavior reduction among HIV-positive Zambian women. J Urban Health. 2005;82(3 Suppl 4):iv92–100.PubMed

19.

Osinowo HO, Olley BO, Adejumo AO. Evaluation of the effect of cognitive therapy on perioperative anxiety and depression among Nigerian surgical patients. West Afr J Med. 2003;22:338–42.PubMed

20.

Bernal G, Bonilla J, Bellido C. Ecological validity and cultural sensitivity for outcome research: issues for cultural adaptation and development of psychosocial treatments with Hispanics. J Abnorm Child Psychol. 1995;23:67–82.CrossRefPubMed

21.

Sue S, Zane N. The role of culture and cultural techniques in psychotherapy. A critique and reformulation. Am Psychol. 1987;42:37–45.CrossRefPubMed

22.

Hall GCN. Psychotherapy research with ethnic minorities: empirical, ethical and conceptual issues. J Consult Clin Psychol. 2001;69:502–10.CrossRefPubMed

23.

Betz NE, Fitzgerald LF. Individual and diversity: theory and research in counseling psychology. Annu Rev Psychol. 1993;44:343–81.CrossRefPubMed

24.

Ramirez M. Multicultural psychotherapy: an approach to individual and cultural differences. Boston: Allyn & Bacon; 1999.

25.

Sue DW, Ivey AE, Petersen PB. A theory of multicultural counseling and therapy. Pacific Grove: Brooks and Cole; 1996.

26.

Rounsaville BJ, Carroll KM, Onken LS. A stage model of behavioral therapies research: getting started and moving on from Stage I. Clin Psychol Sci Pract. 2001;8:133–42.CrossRef

27.

National AIDS and STI Programme, Ministry of Health Kenya. Kenya AIDS Indicator Survey 2007: Preliminary Report. Nairobi, Kenya. Ref Type: Report.

28.

Einterz RM, Kimaiyo S, Mengech HNK, et al. Responding to the HIV pandemic: the power of an academic medical partnership. Acad Med. 2007;82:818.

29.

National AIDS Control Council, Office of the President Kenya. UNGASS 2008 Country Report for Kenya, NACC, Nairobi. Ref Type: Report.

30.

Central Intelligence Agency. CIA—The World Factbook—Kenya. Available at: https://www.cia.gov/library/publications/the-world-factbook/geos/ke.html. Accessed August 2, 2009. Ref Type: Electronic Citation.

31.

World Bank. World Development Report. 2002. Washington, DC, World Bank. Ref Type: Report.

32.

Njenga FG, Kigamwa PA. Mental health policy and programmes in Kenya. 2005. London, Royal College of Psychiatrists. Bulletin of the Board of International Affairs of the Royal College of Psychiatrists. Ref Type: Report.

33.

Ayuku D, Odero W, Kaplan C, De Bruyn R, De Vries M. Social network analysis for health and social interventions among Kenyan scavenging street children. Health Policy Plan. 2003;18:109–18.CrossRefPubMed

34.

POLICY Project—Kenya. From Despair to Hope: Women’s Right to Own and Inherit Property. 2005. Nairobi, Kenya, POLICY Project—Kenya; Kenya National Commission on Human Rights. Ref Type: Report.

35.

Carroll KM, Nich C, Sifry RL, et al. A general system for evaluating therapist adherence and competence in psychotherapy research in the addictions. Drug Alcohol Depend. 2000;57:225–38.CrossRefPubMed

36.

Sobell LC, Sobell MB. Timeline Followback: a technique for assessing self-reported alcohol consumption. In: Litten RZ, Allen J, editors. Measuring alcohol consumption. 1st ed. New Jersey: Humana Press; 1992. p. 41–72.

37.

Sullivan JT, Sykora K, Schneiderman J, Naranjo CA, Sellers EM. Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar). Brit J Addiction. 1989;84:1353–7.CrossRef

38.

Chematics, Inc. Alco-Screen Technical Information. 2004. North Webster, Indiana, Chematics, Inc. Ref Type: Pamphlet.

39.

World Health Organization. WHO—Process of translation and adaptation of instruments. Available at: http://www.who.int/substance_abuse/research_tools/translation/en/index.html. Accessed August 12, 2009. Ref Type: Electronic Citation.

40.

Cohen J. A power primer. Psychol Bull. 1992;112:155–9.CrossRefPubMed

41.

Alio AP, Daley EM, Nana PN, Duan J, Salihu HM. Intimate partner violence and contraception use among women in Sub-Saharan Africa. Int J Gynecol Obstet. 2009 (in press).

42.

Carey MP, Carey KB, Maisto SA, Gordon CM, Schroeder KEE, Vanable PA. Reducing HIV risk behavior among adults receiving outpatient psychiatric treatment: results from a randomized controlled trial. J Consult Clin Psychol. 2004;72:252–68.CrossRefPubMed

Title: Systematic Cultural Adaptation of Cognitive-Behavioral Therapy to Reduce Alcohol Use Among HIV-Infected Outpatients in Western Kenya
Authors: Rebecca K. Papas
John E. Sidle
Steve Martino
Joyce B. Baliddawa
Rogers Songole
Otieno E. Omolo
Benson N. Gakinya
Michael M. Mwaniki
Japheth O. Adina
Tobista Nafula
Willis D. Owino-Ong’or
Kendall J. Bryant
Kathleen M. Carroll
Joseph L. Goulet
Amy C. Justice
Stephen A. Maisto
Publication date: 01-06-2010
Publisher: Springer US
Published in: AIDS and Behavior / Issue 3/2010
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI: https://doi.org/10.1007/s10461-009-9647-6

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