Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.
AIDS Behav. 2010 Jun;14(3):669-78. doi: 10.1007/s10461-009-9647-6.
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.
全世界三分之二的 HIV 感染者生活在撒哈拉以南非洲。酒精的使用通过高危性行为和抗逆转录病毒药物（ARV）治疗依从性差与 HIV 流行有关。在肯尼亚西部，HIV（53%）和普通医学（68%）门诊患者报告存在危险饮酒行为。认知行为治疗（CBT）已被证明可有效减少饮酒。本文报告了一项针对肯尼亚埃尔多雷特的 HIV 感染门诊患者的基于文化的小组非专业人员提供的 CBT 以减少饮酒的系统适应性和试点可行性研究。经过适应性调整和顾问培训，开展了五个试点小组（n=27）。总的出席率为 77%。第 1 次治疗前的无饮酒天数（PDA）为 52-100%（女性）和 21-36%（男性），第 6 次治疗前为 96-100%（女性）和 89-100%（男性）。第 1 次和最后 1 次 CBT 治疗之间的 PDA 效应大小（Cohen's d）为 2.32（女性）和 2.64（男性）。参与者报告了对治疗的满意度。结果表明，在肯尼亚进行 CBT 具有可行性、可接受性和初步疗效。
