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Published in: Addiction Science & Clinical Practice 1/2020

Open Access 01-12-2020 | Human Immunodeficiency Virus | Research

Integrated stepped alcohol treatment for patients with HIV and at-risk alcohol use: a randomized trial

Authors: E. Jennifer Edelman, Stephen A. Maisto, Nathan B. Hansen, Christopher J. Cutter, James Dziura, Yanhong Deng, Lynn E. Fiellin, Patrick G. O’Connor, Roger Bedimo, Cynthia L. Gibert, Vincent C. Marconi, David Rimland, Maria C. Rodriguez-Barradas, Michael S. Simberkoff, Janet P. Tate, Amy C. Justice, Kendall J. Bryant, David A. Fiellin

Published in: Addiction Science & Clinical Practice | Issue 1/2020

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Abstract

Background

At-risk levels of alcohol use threaten the health of patients with HIV (PWH), yet evidence-based strategies to decrease alcohol use and improve HIV-related outcomes in this population are lacking. We examined the effectiveness of integrated stepped alcohol treatment (ISAT) on alcohol use and HIV outcomes among PWH and at-risk alcohol use.

Methods

In this multi-site, randomized trial conducted between January 28, 2013 through July 14, 2017, we enrolled PWH and at-risk alcohol use [defined as alcohol consumption of ≥ 14 drinks per week or ≥ 4 drinks per occasion in men ≤ 65 years old or ≥ 7 drinks per week or ≥ 3 drinks per occasion in women or men > 65 years old]. ISAT (n = 46) involved: Step 1- Brief Negotiated Interview with telephone booster, Step 2- Motivational Enhancement Therapy, and Step 3- Addiction Physician Management. Treatment as usual (TAU) (n = 47) involved receipt of a health handout plus routine care. Analyses were conducted based on intention to treat principles.

Results

Despite a multi-pronged approach, we only recruited 37% of the target population (n = 93/254). Among ISAT participants, 50% advanced to Step 2, among whom 57% advanced to Step 3. Participants randomized to ISAT and TAU had no observed difference in drinks per week over the past 30 days at week 24 (primary outcome) [least square means (Ls mean) (95% CI) = 8.8 vs. 10.6; adjusted mean difference (AMD) (95% CI) =  − 0.4 (− 3.9, 3.0)].

Conclusion

An insufficient number of patients were interested in participating in the trial. Efforts to enhance motivation of PWH with at-risk alcohol use to engage in alcohol-related research and build upon ISAT are needed.
Trial registration Clinicaltrials.gov: NCT01410123, First posted August 4, 2011
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Literature
2.
go back to reference Wood AM, Kaptoge S, Butterworth AS, Willeit P, Warnakula S, Bolton T, et al. Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. Lancet. 2018;391(10129):1513–23.PubMedPubMedCentral Wood AM, Kaptoge S, Butterworth AS, Willeit P, Warnakula S, Bolton T, et al. Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. Lancet. 2018;391(10129):1513–23.PubMedPubMedCentral
3.
go back to reference Williams EC, McGinnis KA, Edelman EJ, Matson TE, Gordon AJ, Marshall BDL, et al. Level of alcohol use associated with HIV care continuum targets in a National U.S. sample of persons living with HIV receiving healthcare. AIDS Behav. 2019;23(1):140–51.PubMedPubMedCentral Williams EC, McGinnis KA, Edelman EJ, Matson TE, Gordon AJ, Marshall BDL, et al. Level of alcohol use associated with HIV care continuum targets in a National U.S. sample of persons living with HIV receiving healthcare. AIDS Behav. 2019;23(1):140–51.PubMedPubMedCentral
4.
go back to reference Justice AC, McGinnis KA, Tate JP, Braithwaite RS, Bryant KJ, Cook RL, et al. Risk of mortality and physiologic injury evident with lower alcohol exposure among HIV infected compared with uninfected men. Drug Alcohol Depend. 2016;161:95–103.PubMedPubMedCentral Justice AC, McGinnis KA, Tate JP, Braithwaite RS, Bryant KJ, Cook RL, et al. Risk of mortality and physiologic injury evident with lower alcohol exposure among HIV infected compared with uninfected men. Drug Alcohol Depend. 2016;161:95–103.PubMedPubMedCentral
5.
go back to reference Edelman EJ, Williams EC, Marshall BDL. Addressing unhealthy alcohol use among people living with HIV: recent advances and research directions. Curr Opin Infect Dis. 2018;31(1):1–7.PubMed Edelman EJ, Williams EC, Marshall BDL. Addressing unhealthy alcohol use among people living with HIV: recent advances and research directions. Curr Opin Infect Dis. 2018;31(1):1–7.PubMed
6.
go back to reference Williams EC, Hahn JA, Saitz R, Bryant K, Lira MC, Samet JH. Alcohol use and human immunodeficiency virus (HIV) infection: current knowledge, implications, and future directions. Alcohol Clin Exp Res. 2016;40(10):2056–72.PubMedPubMedCentral Williams EC, Hahn JA, Saitz R, Bryant K, Lira MC, Samet JH. Alcohol use and human immunodeficiency virus (HIV) infection: current knowledge, implications, and future directions. Alcohol Clin Exp Res. 2016;40(10):2056–72.PubMedPubMedCentral
7.
go back to reference Shuper PA, Joharchi N, Monti PM, Loutfy M, Rehm J. Acute alcohol consumption directly increases HIV transmission risk: a randomized controlled experiment. J Acquir Immune Defic Syndr. 2017;76(5):493–500.PubMedPubMedCentral Shuper PA, Joharchi N, Monti PM, Loutfy M, Rehm J. Acute alcohol consumption directly increases HIV transmission risk: a randomized controlled experiment. J Acquir Immune Defic Syndr. 2017;76(5):493–500.PubMedPubMedCentral
8.
go back to reference US Preventive Services Task Force, Curry SJ, Krist AH, Owens DK, Barry MJ, Caughey AB, et al. Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: US preventive services task force recommendation statement. JAMA. 2018;320(18):1899–909. US Preventive Services Task Force, Curry SJ, Krist AH, Owens DK, Barry MJ, Caughey AB, et al. Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: US preventive services task force recommendation statement. JAMA. 2018;320(18):1899–909.
9.
go back to reference Edelman EJ, Tetrault JM. Unhealthy alcohol use in primary care—the elephant in the examination room. JAMA Intern Med. 2019;179(1):9–10.PubMed Edelman EJ, Tetrault JM. Unhealthy alcohol use in primary care—the elephant in the examination room. JAMA Intern Med. 2019;179(1):9–10.PubMed
10.
go back to reference Institute of Medicine. Improving the quality of health care for mental and substance-use conditions. Washington: Institute of Medicine; 2005. Institute of Medicine. Improving the quality of health care for mental and substance-use conditions. Washington: Institute of Medicine; 2005.
11.
go back to reference Chander G, Monroe AK, Crane HM, Hutton HE, Saag MS, Cropsey K, et al. HIV primary care providers—screening, knowledge, attitudes and behaviors related to alcohol interventions. Drug Alcohol Depend. 2016;161:59–66.PubMedPubMedCentral Chander G, Monroe AK, Crane HM, Hutton HE, Saag MS, Cropsey K, et al. HIV primary care providers—screening, knowledge, attitudes and behaviors related to alcohol interventions. Drug Alcohol Depend. 2016;161:59–66.PubMedPubMedCentral
12.
go back to reference Edelman EJ, Moore BA, Holt SR, Hansen N, Kyriakides TC, Virata M, et al. Efficacy of extended-release naltrexone on HIV-related and drinking outcomes among HIV-positive patients: a randomized-controlled trial. AIDS Behav. 2019;23(1):211–21.PubMedPubMedCentral Edelman EJ, Moore BA, Holt SR, Hansen N, Kyriakides TC, Virata M, et al. Efficacy of extended-release naltrexone on HIV-related and drinking outcomes among HIV-positive patients: a randomized-controlled trial. AIDS Behav. 2019;23(1):211–21.PubMedPubMedCentral
13.
go back to reference Satre DD, Leibowitz AS, Leyden W, Catz SL, Hare CB, Jang H, et al. Interventions to reduce unhealthy alcohol use among primary care patients with HIV: the health and motivation randomized clinical trial. J Gen Intern Med. 2019;34(10):2054–61.PubMed Satre DD, Leibowitz AS, Leyden W, Catz SL, Hare CB, Jang H, et al. Interventions to reduce unhealthy alcohol use among primary care patients with HIV: the health and motivation randomized clinical trial. J Gen Intern Med. 2019;34(10):2054–61.PubMed
14.
go back to reference Chander G, Hutton HE, Lau B, Xu X, McCaul ME. Brief intervention decreases drinking frequency in HIV-infected, heavy drinking women: results of a randomized controlled trial. J Acquir Immune Defic Syndr. 2015;70(2):137–45.PubMedPubMedCentral Chander G, Hutton HE, Lau B, Xu X, McCaul ME. Brief intervention decreases drinking frequency in HIV-infected, heavy drinking women: results of a randomized controlled trial. J Acquir Immune Defic Syndr. 2015;70(2):137–45.PubMedPubMedCentral
15.
go back to reference Kahler CW, Pantalone DW, Mastroleo NR, Liu T, Bove G, Ramratnam B, et al. Motivational interviewing with personalized feedback to reduce alcohol use in HIV-infected men who have sex with men: a randomized controlled trial. J Consult Clin Psychol. 2018;86(8):645–56.PubMedPubMedCentral Kahler CW, Pantalone DW, Mastroleo NR, Liu T, Bove G, Ramratnam B, et al. Motivational interviewing with personalized feedback to reduce alcohol use in HIV-infected men who have sex with men: a randomized controlled trial. J Consult Clin Psychol. 2018;86(8):645–56.PubMedPubMedCentral
16.
go back to reference Hasin DS, Aharonovich E, O'Leary A, Greenstein E, Pavlicova M, Arunajadai S, et al. Reducing heavy drinking in HIV primary care: a randomized trial of brief intervention, with and without technological enhancement. Addiction. 2013;108(7):1230–40.PubMedPubMedCentral Hasin DS, Aharonovich E, O'Leary A, Greenstein E, Pavlicova M, Arunajadai S, et al. Reducing heavy drinking in HIV primary care: a randomized trial of brief intervention, with and without technological enhancement. Addiction. 2013;108(7):1230–40.PubMedPubMedCentral
17.
go back to reference Scott-Sheldon LAJ, Carey KB, Johnson BT, Carey MP, Team MR. Behavioral interventions targeting alcohol use among people living with HIV/AIDS: a systematic review and meta-analysis. AIDS Behav. 2017;21(Suppl 2):126–43.PubMedPubMedCentral Scott-Sheldon LAJ, Carey KB, Johnson BT, Carey MP, Team MR. Behavioral interventions targeting alcohol use among people living with HIV/AIDS: a systematic review and meta-analysis. AIDS Behav. 2017;21(Suppl 2):126–43.PubMedPubMedCentral
18.
go back to reference Bair MJ, Ang D, Wu J, Outcalt SD, Sargent C, Kempf C, et al. Evaluation of stepped care for chronic pain (ESCAPE) in veterans of the Iraq and Afghanistan conflicts: a randomized clinical trial. JAMA Intern Med. 2015;175(5):682–9.PubMed Bair MJ, Ang D, Wu J, Outcalt SD, Sargent C, Kempf C, et al. Evaluation of stepped care for chronic pain (ESCAPE) in veterans of the Iraq and Afghanistan conflicts: a randomized clinical trial. JAMA Intern Med. 2015;175(5):682–9.PubMed
19.
go back to reference van Straten A, Hill J, Richards DA, Cuijpers P. Stepped care treatment delivery for depression: a systematic review and meta-analysis. Psychol Med. 2015;45(2):231–46.PubMed van Straten A, Hill J, Richards DA, Cuijpers P. Stepped care treatment delivery for depression: a systematic review and meta-analysis. Psychol Med. 2015;45(2):231–46.PubMed
20.
go back to reference Coulton S, Bland M, Crosby H, Dale V, Drummond C, Godfrey C, et al. Effectiveness and cost-effectiveness of opportunistic screening and stepped-care interventions for older alcohol users in primary care. Alcohol Alcohol. 2017;52(6):655–64.PubMed Coulton S, Bland M, Crosby H, Dale V, Drummond C, Godfrey C, et al. Effectiveness and cost-effectiveness of opportunistic screening and stepped-care interventions for older alcohol users in primary care. Alcohol Alcohol. 2017;52(6):655–64.PubMed
21.
go back to reference Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Dziura J, Deng Y, et al. Integrated stepped alcohol treatment for patients with HIV and liver disease: a randomized trial. J Subst Abuse Treat. 2019;106:97–106.PubMed Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Dziura J, Deng Y, et al. Integrated stepped alcohol treatment for patients with HIV and liver disease: a randomized trial. J Subst Abuse Treat. 2019;106:97–106.PubMed
22.
go back to reference Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Dziura J, Deng Y, et al. Integrated stepped alcohol treatment for patients with HIV and alcohol use disorder: a randomised controlled trial. Lancet HIV. 2019;6(8):e509–e517517.PubMed Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Dziura J, Deng Y, et al. Integrated stepped alcohol treatment for patients with HIV and alcohol use disorder: a randomised controlled trial. Lancet HIV. 2019;6(8):e509–e517517.PubMed
23.
go back to reference Agabio R, Leggio L. HIV and alcohol use disorder: we cannot ignore the elephant in the room. Lancet HIV. 2019;6(8):e485–e486486.PubMed Agabio R, Leggio L. HIV and alcohol use disorder: we cannot ignore the elephant in the room. Lancet HIV. 2019;6(8):e485–e486486.PubMed
25.
go back to reference Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Dziura J, Fiellin LE, et al. The starting treatment for ethanol in primary care trials (STEP Trials): protocol for three parallel multi-site stepped care effectiveness studies for unhealthy alcohol use in HIV-positive patients. Contemp Clin Trials. 2017;52:80–90.PubMed Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Dziura J, Fiellin LE, et al. The starting treatment for ethanol in primary care trials (STEP Trials): protocol for three parallel multi-site stepped care effectiveness studies for unhealthy alcohol use in HIV-positive patients. Contemp Clin Trials. 2017;52:80–90.PubMed
26.
go back to reference Witkiewitz K, Finney JW, Harris AH, Kivlahan DR, Kranzler HR. Recommendations for the design and analysis of treatment trials for alcohol use disorders. Alcohol Clin Exp Res. 2015;39(9):1557–700.PubMedPubMedCentral Witkiewitz K, Finney JW, Harris AH, Kivlahan DR, Kranzler HR. Recommendations for the design and analysis of treatment trials for alcohol use disorders. Alcohol Clin Exp Res. 2015;39(9):1557–700.PubMedPubMedCentral
27.
go back to reference Edelman EJ, Hansen NB, Cutter CJ, Danton C, Fiellin LE, O'Connor PG, et al. Implementation of integrated stepped care for unhealthy alcohol use in HIV clinics. Addict Sci Clin Pract. 2016;11(1):1.PubMedPubMedCentral Edelman EJ, Hansen NB, Cutter CJ, Danton C, Fiellin LE, O'Connor PG, et al. Implementation of integrated stepped care for unhealthy alcohol use in HIV clinics. Addict Sci Clin Pract. 2016;11(1):1.PubMedPubMedCentral
28.
go back to reference Sobell LC, Sobell SM, Alcohol Timeline Followback (TLFB). Handbook of psychiatric measures. Washington: American Psychiatric Association; 1996. Sobell LC, Sobell SM, Alcohol Timeline Followback (TLFB). Handbook of psychiatric measures. Washington: American Psychiatric Association; 1996.
29.
go back to reference American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington: American Psychiatric Press; 2013. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington: American Psychiatric Press; 2013.
30.
go back to reference D'Onofrio G, Fiellin DA, Pantalon MV, Chawarski MC, Owens PH, Degutis LC, et al. A brief intervention reduces hazardous and harmful drinking in emergency department patients. Ann Emerg Med. 2012;60(2):181–92.PubMed D'Onofrio G, Fiellin DA, Pantalon MV, Chawarski MC, Owens PH, Degutis LC, et al. A brief intervention reduces hazardous and harmful drinking in emergency department patients. Ann Emerg Med. 2012;60(2):181–92.PubMed
31.
go back to reference Fleming MF, Barry KL, Manwell LB, Johnson K, London R. Brief physician advice for problem alcohol drinkers. A randomized controlled trial in community-based primary care practices. JAMA. 1997;277(13):1039–45.PubMed Fleming MF, Barry KL, Manwell LB, Johnson K, London R. Brief physician advice for problem alcohol drinkers. A randomized controlled trial in community-based primary care practices. JAMA. 1997;277(13):1039–45.PubMed
32.
go back to reference Maisto SA, Conigliaro J, McNeil M, Kraemer K, Conigliaro RL, Kelley ME. Effects of two types of brief intervention and readiness to change on alcohol use in hazardous drinkers. J Stud Alcohol. 2001;62(5):605–14.PubMed Maisto SA, Conigliaro J, McNeil M, Kraemer K, Conigliaro RL, Kelley ME. Effects of two types of brief intervention and readiness to change on alcohol use in hazardous drinkers. J Stud Alcohol. 2001;62(5):605–14.PubMed
33.
go back to reference Fiellin DA, Pantalon MV, Chawarski MC, Moore BA, Sullivan LE, O'Connor PG, et al. Counseling plus buprenorphine-naloxone maintenance therapy for opioid dependence. N Engl J Med. 2006;355(4):365–74.PubMed Fiellin DA, Pantalon MV, Chawarski MC, Moore BA, Sullivan LE, O'Connor PG, et al. Counseling plus buprenorphine-naloxone maintenance therapy for opioid dependence. N Engl J Med. 2006;355(4):365–74.PubMed
34.
go back to reference Tetrault JM, Moore BA, Barry DT, O'Connor PG, Schottenfeld R, Fiellin DA, et al. Brief versus extended counseling along with buprenorphine/naloxone for HIV-infected opioid dependent patients. J Subst Abuse Treat. 2012;43(4):433–9.PubMed Tetrault JM, Moore BA, Barry DT, O'Connor PG, Schottenfeld R, Fiellin DA, et al. Brief versus extended counseling along with buprenorphine/naloxone for HIV-infected opioid dependent patients. J Subst Abuse Treat. 2012;43(4):433–9.PubMed
36.
go back to reference Nadkarni PM, Brandt C, Frawley S, Sayward FG, Einbinder R, Zelterman D, et al. Managing attribute—value clinical trials data using the ACT/DB client-server database system. J Am Med Inform Assoc. 1998;5(2):139–51.PubMedPubMedCentral Nadkarni PM, Brandt C, Frawley S, Sayward FG, Einbinder R, Zelterman D, et al. Managing attribute—value clinical trials data using the ACT/DB client-server database system. J Am Med Inform Assoc. 1998;5(2):139–51.PubMedPubMedCentral
37.
go back to reference Jonas DE, Amick HR, Feltner C, Bobashev G, Thomas K, Wines R, et al. Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis. JAMA. 2014;311(18):1889–900.PubMed Jonas DE, Amick HR, Feltner C, Bobashev G, Thomas K, Wines R, et al. Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis. JAMA. 2014;311(18):1889–900.PubMed
38.
go back to reference Soyka M, Lieb M. Recent developments in pharmacotherapy of alcoholism. Pharmacopsychiatry. 2015;48(4–5):123–35.PubMed Soyka M, Lieb M. Recent developments in pharmacotherapy of alcoholism. Pharmacopsychiatry. 2015;48(4–5):123–35.PubMed
39.
go back to reference Wurst FM, Thon N, Yegles M, Schruck A, Preuss UW, Weinmann W. Ethanol metabolites: their role in the assessment of alcohol intake. Alcohol Clin Exp Res. 2015;39(11):2060–72. PubMed Wurst FM, Thon N, Yegles M, Schruck A, Preuss UW, Weinmann W. Ethanol metabolites: their role in the assessment of alcohol intake. Alcohol Clin Exp Res. 2015;39(11):2060–72. PubMed
40.
go back to reference Tate JP, Justice AC, Hughes MD, Bonnet F, Reiss P, Mocroft A, et al. An internationally generalizable risk index for mortality after one year of antiretroviral therapy. AIDS. 2013;27(4):563–72.PubMedPubMedCentral Tate JP, Justice AC, Hughes MD, Bonnet F, Reiss P, Mocroft A, et al. An internationally generalizable risk index for mortality after one year of antiretroviral therapy. AIDS. 2013;27(4):563–72.PubMedPubMedCentral
41.
go back to reference Marshall BDL, Tate JP, McGinnis KA, Bryant KJ, Cook RL, Edelman EJ, et al. Long-term alcohol use patterns and HIV disease severity. AIDS. 2017;31(9):1313–21.PubMedPubMedCentral Marshall BDL, Tate JP, McGinnis KA, Bryant KJ, Cook RL, Edelman EJ, et al. Long-term alcohol use patterns and HIV disease severity. AIDS. 2017;31(9):1313–21.PubMedPubMedCentral
42.
go back to reference Williams EC, McGinnis KA, Tate JP, Matson TE, Rubinsky AD, Bobb JF, et al. HIV disease severity is sensitive to temporal changes in alcohol use: a national study of VA patients with HIV. J Acquir Immune Defic Syndr. 2019;81(4):448–55.PubMed Williams EC, McGinnis KA, Tate JP, Matson TE, Rubinsky AD, Bobb JF, et al. HIV disease severity is sensitive to temporal changes in alcohol use: a national study of VA patients with HIV. J Acquir Immune Defic Syndr. 2019;81(4):448–55.PubMed
43.
go back to reference Rochon J, Bhapkar M, Pieper CF, Kraus WE. Application of the marginal structural model to account for suboptimal adherence in a randomized controlled trial. Contemp Clin Trials Commun. 2016;4:222–8.PubMedPubMedCentral Rochon J, Bhapkar M, Pieper CF, Kraus WE. Application of the marginal structural model to account for suboptimal adherence in a randomized controlled trial. Contemp Clin Trials Commun. 2016;4:222–8.PubMedPubMedCentral
44.
go back to reference Sullivan LE, Tetrault JM, Braithwaite RS, Turner BJ, Fiellin DA. A meta-analysis of the efficacy of nonphysician brief interventions for unhealthy alcohol use: implications for the patient-centered medical home. Am J Addict. 2011;20(4):343–56.PubMed Sullivan LE, Tetrault JM, Braithwaite RS, Turner BJ, Fiellin DA. A meta-analysis of the efficacy of nonphysician brief interventions for unhealthy alcohol use: implications for the patient-centered medical home. Am J Addict. 2011;20(4):343–56.PubMed
45.
go back to reference Frost MC, Glass JE, Bradley KA, Williams EC. Documented brief intervention associated with reduced linkage to specialty addictions treatment in a national sample of VA patients with unhealthy alcohol use with and without alcohol use disorders. Addiction. 2020;115(4):668–78.PubMed Frost MC, Glass JE, Bradley KA, Williams EC. Documented brief intervention associated with reduced linkage to specialty addictions treatment in a national sample of VA patients with unhealthy alcohol use with and without alcohol use disorders. Addiction. 2020;115(4):668–78.PubMed
46.
go back to reference Hart CL, Davey Smith G, Gruer L, Watt GC. The combined effect of smoking tobacco and drinking alcohol on cause-specific mortality: a 30 year cohort study. BMC Public Health. 2010;10:789.PubMedPubMedCentral Hart CL, Davey Smith G, Gruer L, Watt GC. The combined effect of smoking tobacco and drinking alcohol on cause-specific mortality: a 30 year cohort study. BMC Public Health. 2010;10:789.PubMedPubMedCentral
47.
go back to reference Petoumenos K, Law MG. Smoking, alcohol and illicit drug use effects on survival in HIV-positive persons. Curr Opin HIV AIDS. 2016;11(5):514–20.PubMed Petoumenos K, Law MG. Smoking, alcohol and illicit drug use effects on survival in HIV-positive persons. Curr Opin HIV AIDS. 2016;11(5):514–20.PubMed
49.
go back to reference Elliott JC, Aharonovich E, O'Leary A, Johnston B, Hasin DS. Perceived medical risks of drinking, alcohol consumption, and hepatitis C status among heavily drinking HIV primary care patients. Alcohol Clin Exp Res. 2014;38(12):3052–9.PubMedPubMedCentral Elliott JC, Aharonovich E, O'Leary A, Johnston B, Hasin DS. Perceived medical risks of drinking, alcohol consumption, and hepatitis C status among heavily drinking HIV primary care patients. Alcohol Clin Exp Res. 2014;38(12):3052–9.PubMedPubMedCentral
50.
go back to reference Elliott JC, Aharonovich E, O'Leary A, Wainberg M, Hasin DS. Drinking motives among HIV primary care patients. AIDS Behav. 2014;18(7):1315–23.PubMedPubMedCentral Elliott JC, Aharonovich E, O'Leary A, Wainberg M, Hasin DS. Drinking motives among HIV primary care patients. AIDS Behav. 2014;18(7):1315–23.PubMedPubMedCentral
51.
go back to reference Fredericksen RJ, Edwards TC, Merlin JS, Gibbons LE, Rao D, Batey DS, et al. Patient and provider priorities for self-reported domains of HIV clinical care. AIDS Care. 2015;27(10):1255–64.PubMedPubMedCentral Fredericksen RJ, Edwards TC, Merlin JS, Gibbons LE, Rao D, Batey DS, et al. Patient and provider priorities for self-reported domains of HIV clinical care. AIDS Care. 2015;27(10):1255–64.PubMedPubMedCentral
52.
go back to reference Cook RL, Weber KM, Mai D, Thoma K, Hu X, Brumback B, et al. Acceptability and feasibility of a randomized clinical trial of oral naltrexone vs. placebo for women living with HIV infection: Study design challenges and pilot study results. Contemp Clin Trials. 2017;60:72–7.PubMedPubMedCentral Cook RL, Weber KM, Mai D, Thoma K, Hu X, Brumback B, et al. Acceptability and feasibility of a randomized clinical trial of oral naltrexone vs. placebo for women living with HIV infection: Study design challenges and pilot study results. Contemp Clin Trials. 2017;60:72–7.PubMedPubMedCentral
54.
go back to reference McLellan AT, Kushner H, Metzger D, Peters R, Smith I, Grissom G, et al. The fifth edition of the addiction severity index. J Subst Abuse Treat. 1992;9(3):199–21313.PubMed McLellan AT, Kushner H, Metzger D, Peters R, Smith I, Grissom G, et al. The fifth edition of the addiction severity index. J Subst Abuse Treat. 1992;9(3):199–21313.PubMed
55.
go back to reference Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.PubMedPubMedCentral Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.PubMedPubMedCentral
Metadata
Title
Integrated stepped alcohol treatment for patients with HIV and at-risk alcohol use: a randomized trial
Authors
E. Jennifer Edelman
Stephen A. Maisto
Nathan B. Hansen
Christopher J. Cutter
James Dziura
Yanhong Deng
Lynn E. Fiellin
Patrick G. O’Connor
Roger Bedimo
Cynthia L. Gibert
Vincent C. Marconi
David Rimland
Maria C. Rodriguez-Barradas
Michael S. Simberkoff
Janet P. Tate
Amy C. Justice
Kendall J. Bryant
David A. Fiellin
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Addiction Science & Clinical Practice / Issue 1/2020
Electronic ISSN: 1940-0640
DOI
https://doi.org/10.1186/s13722-020-00200-y

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