Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 550 N Broadway, Suite 115, Baltimore, MD, 21205, USA.
Department of Psychiatry and Behavioral Neurobiology, University of Alabama At Birmingham, Birmingham, AL, USA.
AIDS Behav. 2021 Dec;25(12):4074-4084. doi: 10.1007/s10461-021-03295-9. Epub 2021 May 16.
This prospective, nonrandomized implementation study evaluated a computerized brief intervention (CBI) for persons with HIV (PWH) and heavy/hazardous alcohol use. CBI was integrated into two HIV primary care clinics. Eligible patients were engaged in care, ≥ 18 years old, English speaking, endorsed heavy/hazardous alcohol use on the Alcohol Use Disorders Identification Test-C (AUDIT-C). Two 20-min computerized sessions using cognitive behavioral techniques were delivered by a 3-D avatar on touch screen tablets. Of 816 eligible AUDIT-C scores, 537 (66%) resulted in CBI invitation, 226 (42%) of invited patients enrolled, and 176 (78%) of enrolled patients watched at least one session. CBI enrollment was associated with a significant average reduction of 9.1 drinks/week (95% CI - 14.5, - 3.6) 4-12 months post-enrollment. Among those who participated in one or both sessions, average reduction in drinks/week was 11.7 drinks/week (95% CI - 18.8, - 4.6). There was corresponding improvement in AUDIT-C scores. Overall patients reported high levels of intervention satisfaction, particularly among older and Black patients. These promising results point to a practical intervention for alcohol reduction in this vulnerable patient population with elevated rates of heavy/hazardous drinking. Future research should examine strategies to increase initial engagement, strengthen intervention effects to increase the number of patients who achieve non-hazardous drinking, and examine the duration of therapeutic effects.
本前瞻性、非随机实施研究评估了一种针对艾滋病毒感染者(PWH)和重度/危险饮酒者的计算机化简短干预(CBI)。CBI 整合到两家 HIV 初级保健诊所中。符合条件的患者正在接受治疗,年龄≥18 岁,英语流利,在酒精使用障碍识别测试-C(AUDIT-C)上表示重度/危险饮酒。使用认知行为技术,通过 3D 头像在触摸屏平板电脑上进行两次 20 分钟的计算机化会话。在 816 份符合条件的 AUDIT-C 评分中,有 537 份(66%)导致 CBI 邀请,226 份(42%)受邀患者入组,176 份(78%)入组患者观看了至少一次会话。CBI 入组与入组后 4-12 个月平均每周饮酒量减少 9.1 份(95%CI-14.5,-3.6)显著相关。在参加了一次或两次会话的患者中,每周饮酒量平均减少 11.7 份(95%CI-18.8,-4.6)。AUDIT-C 评分也相应改善。总体而言,患者对干预措施的满意度较高,尤其是年龄较大和黑人患者。这些有希望的结果表明,对于饮酒量较高的这一脆弱患者群体,CBI 是一种实用的减少饮酒量的干预措施。未来的研究应探讨增加初始参与度的策略,加强干预效果,以增加达到非危险饮酒的患者数量,并检查治疗效果的持续时间。
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