Center for Alcohol and Addiction Studies.
The Fenway Institute, Fenway Health Boston.
J Consult Clin Psychol. 2018 Aug;86(8):645-656. doi: 10.1037/ccp0000322.
This randomized controlled trial tested the efficacy of motivational interviewing (MI) to reduce alcohol use among heavy drinking men who have sex with men (MSM) who are engaged in HIV care but not currently receiving addictions treatment.
One hundred eighty MSM living with HIV-recruited regardless of interest in changing drinking-were randomly assigned to MI or an assessment-only treatment as usual (TAU) control. MI comprised one in-person session followed by two brief phone calls and in-person booster sessions at 3 and 6 months. The Timeline Follow-Back Interview assessed past 30-day alcohol use and sexual behavior at 3, 6, and 12 months postbaseline, and serum samples and medical records assessed viral load, CD4 cell count, and liver function.
At 6 and 12 months, MI compared to TAU resulted in significantly fewer drinks per week (6 months: b = -8.72, 95% confidence interval (CI) [-12.69, -4.76]; 12 months: b = -5.98, 95% CI [-9.77, -2.19]) and lower number of heavy drinking days (6 months: incidence rate ratio = 0.55, 95% CI [0.38, 0.79]; 12 months: incidence rate ratio = 0.50, 95% CI [0.33, 0.78]). Effects on viral load, CD4 cell count, and liver function were nonsignificant. Among those reporting condomless sex with nonsteady partners at baseline, MI resulted in significantly lower rates of this behavior at 3 and 12 months compared to TAU.
In MSM living with HIV, MI shows substantial promise for reducing heavy drinking and for reducing condomless sex among those at risk. (PsycINFO Database Record
本随机对照试验旨在检验动机性访谈（MI）在减少接受 HIV 护理但未接受成瘾治疗的男男性行为者（MSM）中的饮酒量的效果，这些 MSM 存在重度饮酒行为。
无论是否有改变饮酒的意愿，180 名 HIV 感染者的 MSM 参与者被随机分配到 MI 或评估仅作为常规治疗（TAU）的对照组。MI 包括一次面对面的咨询，然后是两次简短的电话咨询，并在 3 个月和 6 个月时进行面对面的强化咨询。时间线随访访谈评估了过去 30 天的饮酒和性行为，在基线后 3、6 和 12 个月进行，血清样本和医疗记录评估了病毒载量、CD4 细胞计数和肝功能。
在 6 个月和 12 个月时，与 TAU 相比，MI 导致每周饮酒量显著减少（6 个月：b = -8.72，95%置信区间 [CI] [-12.69, -4.76]；12 个月：b = -5.98，95% CI [-9.77, -2.19]），并且重度饮酒天数减少（6 个月：发病率比 = 0.55，95% CI [0.38, 0.79]；12 个月：发病率比 = 0.50，95% CI [0.33, 0.78]）。对病毒载量、CD4 细胞计数和肝功能的影响不显著。在基线时报告与非固定伴侣发生无保护性行为的参与者中，与 TAU 相比，MI 在 3 个月和 12 个月时显著降低了这种行为的发生率。
在 HIV 感染者的 MSM 中，MI 显示出减少重度饮酒和降低高危人群无保护性行为的巨大潜力。
