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Open Access 01-12-2019 | Care | Research

Intervention for alcohol use disorders at an HIV care clinic in Harare: a pilot and feasibility study

Authors: Munyaradzi Madhombiro, Bazondlile Dube, Michelle Dube, Moleen Zunza, Dixon Chibanda, Simbarashe Rusakaniko, Soraya Seedat

Published in: Addiction Science & Clinical Practice | Issue 1/2019

Abstract

Background

Alcohol use in HIV infected patients is associated with risky sexual behaviour, poor adherence to Highly Active Antiretroviral Therapy, treatment failure and increased physiologic harm. The objectives of the study were to pilot the outcome assessments to be used in the trial proper, assess the feasibility of delivery of a brief MI/CBT intervention compared to an WHO mhGAP intervention for problematic alcohol use in PLWH in Zimbabwe, and pilot the effectiveness (on alcohol use, functionality and CD4 count) of these interventions at 3 months in a randomised controlled trial design.

Methods

An intervention for HIV infected patients with problematic alcohol use, developed through adaptation of existing evidence based psychological treatments, was assessed for its feasibility at a tertiary HIV care clinic in Zimbabwe. Registered general nurses, using a manualised protocol, delivered the intervention. Forty patients were recruited and randomised to receive either an MI/CBT intervention or the WHO mhGAP Intervention Guide for AUDs (n = 20 patients per group).

Results

Out of 40 participants enrolled, 31 were successfully followed up for 3 months with a loss to follow-up rate of 23%. There was a statistically significant decrease in AUDIT score over time in both groups (p < 0.001), however no statistically significant group difference with a mean difference of 0.80, standard error of 2.07 and p = 0.70. For the CD4 count, the median and interquartile ranges at baseline for MI/CBT and WHO mhGAP IG groups were 218 (274) and 484 (211.50), respectively. At follow-up, median and interquartile ranges for the CD4 count for MI/CBT and WHO mhGAP IG groups were 390 (280) and 567 (378), respectively, indicative of improvement in immunological parameters in both arms.

Conclusion

The findings from this pilot study suggests that a brief MI/CBT delivered by Registered General Nurses for problematic alcohol use is feasible in this population but will require the implementation of additional measures to improve retention. However, mechanisms to improve retention need special attention.

Trial registration Pan African Clinical Trial Registry, current PACTR201509001211149

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Title: Intervention for alcohol use disorders at an HIV care clinic in Harare: a pilot and feasibility study
Authors: Munyaradzi Madhombiro
Bazondlile Dube
Michelle Dube
Moleen Zunza
Dixon Chibanda
Simbarashe Rusakaniko
Soraya Seedat
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Care
Human Immunodeficiency Virus
Published in: Addiction Science & Clinical Practice / Issue 1/2019
Electronic ISSN: 1940-0640
DOI: https://doi.org/10.1186/s13722-019-0143-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Intervention for alcohol use disorders at an HIV care clinic in Harare: a pilot and feasibility study

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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