Armstrong M L, LaPlante A M, Altice F L, Copenhaver M, Molina P E
Comprehensive Alcohol Research Center and Alcohol and Drug Abuse Center, Department of Physiology, LSUHSC, New Orleans, LA 70112, USA.
Yale University School of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, CT 06510, USA ; Yale University School of Public Health, Division of Epidemiology of Microbial Diseases, New Haven, CT 06510, USA.
AIDS Res Treat. 2015;2015:879052. doi: 10.1155/2015/879052. Epub 2015 Dec 1.
Alcohol use disorders (AUDs) are highly prevalent among people living with HIV/AIDS (PLWHA) and are associated with increased HIV risk behaviors, suboptimal treatment adherence, and greater risk for disease progression. We used the ADAPT-ITT strategy to adapt an evidence-based intervention (EBI), the Holistic Health Recovery Program (HHRP+), that focuses on secondary HIV prevention and antiretroviral therapy (ART) adherence and apply it to PLWHA with problematic drinking. Focus groups (FGs) were conducted with PLWHA who consume alcohol and with treatment providers at the largest HIV primary care clinic in New Orleans, LA. Overall themes that emerged from the FGs included the following: (1) negative mood states contribute to heavy alcohol consumption in PLWHA; (2) high levels of psychosocial stress, paired with few adaptive coping strategies, perpetuate the use of harmful alcohol consumption in PLWHA; (3) local cultural norms are related to the permissiveness and pervasiveness of drinking and contribute to heavy alcohol use; (4) healthcare providers unanimously stated that outpatient options for AUD intervention are scarce, (5) misperceptions about the relationships between alcohol and HIV are common; (6) PLWHA are interested in learning about alcohol's impact on ART and HIV disease progression. These data were used to design the adapted EBI.
酒精使用障碍（AUDs）在艾滋病毒/艾滋病感染者（PLWHA）中非常普遍，并且与艾滋病毒风险行为增加、治疗依从性欠佳以及疾病进展风险增加有关。我们采用了ADAPT-ITT策略来调整一种基于证据的干预措施（EBI），即整体健康恢复计划（HHRP+），该计划侧重于艾滋病毒二级预防和抗逆转录病毒疗法（ART）依从性，并将其应用于有饮酒问题的PLWHA。我们在路易斯安那州新奥尔良市最大的艾滋病毒初级保健诊所，对饮酒的PLWHA和治疗提供者进行了焦点小组访谈（FGs）。焦点小组访谈中出现的总体主题包括：（1）负面情绪状态导致PLWHA大量饮酒；（2）高水平的心理社会压力，加上很少有适应性应对策略，使PLWHA持续有害饮酒；（3）当地文化规范与饮酒的宽容度和普遍性有关，并导致大量饮酒；（4）医疗保健提供者一致表示，AUD干预的门诊选择很少；（5）对酒精与艾滋病毒之间关系的误解很常见；（6）PLWHA有兴趣了解酒精对ART和艾滋病毒疾病进展的影响。这些数据被用于设计调整后的EBI。
