Kahler Christopher W, Surace Anthony, Durst Ayla, Pantalone David W, Mastroleo Nadine R, Miguez Maria Jose, Bueno Diego, Liu Tao, Monti Peter M, Mayer Kenneth H
Center for Alcohol and Addiction Studies and the Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA.
The Fenway Institute, Fenway Health Boston, MA, USA.
Contemp Clin Trials Commun. 2019 Oct 18;16:100475. doi: 10.1016/j.conctc.2019.100475. eCollection 2019 Dec.
Heavy alcohol use is prevalent among men who have sex with men (MSM) living with HIV and is associated with reduced antiretroviral therapy adherence, reduced HIV viral suppression, and reduced survival. We recently found that compared to HIV treatment as usual, three sessions of in-person motivational interviewing (MI) substantially reduced drinking in MSM with HIV. In an effort to enhance the effectiveness and efficiency of this intervention, the present study will test whether MI is more effective than brief intervention when delivered by videoconferencing, whether interactive text messaging (ITM) can enhance the effects of alcohol intervention, and whether extended duration of intervention is more effective than brief duration.
Using a 2 × 2 × 2 factorial design, we will randomly assign 224 heavy-drinking MSM with HIV to: MI or brief intervention (BI); ITM or no ITM; Standard or Extended intervention (EI). All participants will receive intervention immediately after baseline assessment via videoconferencing and at 1-month post baseline via telephone. Participants randomized to EI will receive additional intervention sessions at 3, 6, and 9 months. Participants randomized to ITM will receive daily interactive texts about alcohol use for 1 month, with those randomized to EI receiving weekly interactive texts through 9 months. Alcohol and HIV-related outcomes will be assessed at 6 and 12 months post baseline.
By testing the combinations of interventions that can most effectively reduce alcohol use among MSM with HIV, this study will set the stage for wider-scale implementation of an optimized intervention combination.
在感染艾滋病毒的男男性行为者（MSM）中，大量饮酒的情况很普遍，且与抗逆转录病毒疗法依从性降低、艾滋病毒病毒抑制减弱及生存率降低有关。我们最近发现，与常规艾滋病毒治疗相比，三次面对面的动机性访谈（MI）大幅减少了感染艾滋病毒的男男性行为者的饮酒量。为提高这种干预措施的有效性和效率，本研究将测试通过视频会议进行动机性访谈是否比简短干预更有效，交互式短信（ITM）能否增强酒精干预的效果，以及延长干预时长是否比简短干预更有效。
采用2×2×2析因设计，我们将把224名大量饮酒的感染艾滋病毒的男男性行为者随机分为：动机性访谈组或简短干预组（BI）；交互式短信组或无交互式短信组；标准干预组或延长干预组（EI）。所有参与者将在基线评估后立即通过视频会议接受干预，并在基线后1个月通过电话接受干预。随机分配到延长干预组的参与者将在3个月、6个月和9个月接受额外的干预课程。随机分配到交互式短信组的参与者将在1个月内每天收到关于饮酒的交互式短信，随机分配到延长干预组的参与者将在9个月内每周收到交互式短信。将在基线后6个月和12个月评估酒精及与艾滋病毒相关的结果。
通过测试能最有效减少感染艾滋病毒的男男性行为者饮酒量的干预措施组合，本研究将为更广泛地实施优化干预组合奠定基础。
