南非使用移动呼气酒精检测仪对夫妇进行动机性访谈以减少饮酒：Masibambisane 的一项试点随机对照试验。

Couples motivational interviewing with mobile breathalysers to reduce alcohol use in South Africa: a pilot randomised controlled trial of Masibambisane.

机构信息

Centre for Community Based Research, Human Sciences Research Council, Pietermaritzburg, South Africa.

Center for AIDS Prevention Studies, Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, California, USA.

出版信息

BMJ Open. 2024 Jan 30;14(1):e083390. doi: 10.1136/bmjopen-2023-083390.

DOI:10.1136/bmjopen-2023-083390

PMID:38296300

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10828841/

Abstract

INTRODUCTION

Heavy alcohol use among people living with HIV in sub-Saharan Africa can hinder the success of HIV treatment programmes, impacting progress towards United Nations Programme on HIV/AIDS goals. Primary partners can provide critical forms of social support to reduce heavy drinking and could be included in motivational interviewing (MI) interventions to address heavy drinking; however, few studies have evaluated MI interventions for couples living with HIV in sub-Saharan Africa. We aim to evaluate the feasibility and acceptability of a couple-based MI intervention with mobile breathalyser technology to reduce heavy alcohol use and improve HIV treatment outcomes among HIV-affected couples in South Africa.

METHODS AND ANALYSIS

We will employ a three-arm randomised controlled trial to assess the efficacy of couple-based MI (MI-only arm) and in conjunction with mobile breathalysers (MI-plus arm) to address alcohol use and HIV outcomes, as compared with enhanced usual care (control arm). We will enrol heterosexual couples aged 18-49 in a primary relationship for at least 6 months who have at least one partner reporting hazardous alcohol use and on antiretroviral therapy for 6 months. Participants in both MI arms will attend three manualised counselling sessions and those in the MI-plus arm will receive real-time feedback on blood alcohol concentration levels using a mobile breathalyser. Couples randomised in the control arm will receive enhanced usual care based on the South African ART Clinical Guidelines. Feasibility and acceptability indicators will be analysed descriptively, and exploratory hypotheses will be examined through regression models considering time points and treatment arms.

ETHICS AND DISSEMINATION

The study was approved by the University of California, San Francisco (HRPP; protocol number 21-35034) and Human Sciences Research Council Research Ethics Committee (REC: protocol number 1/27/20/21). We will disseminate the results at local community meetings, community-level health gatherings and conferences focused on HIV and alcohol use.

TRIAL REGISTRATION NUMBER

NCT05756790.

摘要

介绍

在撒哈拉以南非洲地区，艾滋病毒感染者大量饮酒会阻碍艾滋病毒治疗项目的成功，影响联合国艾滋病毒/艾滋病规划署目标的进展。主要伴侣可以提供重要的社会支持，以减少大量饮酒，并且可以纳入动机访谈（MI）干预措施来解决大量饮酒问题；然而，很少有研究评估过在撒哈拉以南非洲地区针对感染艾滋病毒的夫妇的 MI 干预措施。我们旨在评估一种基于夫妇的 MI 干预措施与移动呼气酒精测试技术相结合，以减少受艾滋病毒影响的夫妇中大量饮酒并改善艾滋病毒治疗结果的可行性和可接受性，该研究在南非进行。

方法和分析

我们将采用三臂随机对照试验来评估基于夫妇的 MI（仅 MI 组）和与移动呼气酒精测试器结合使用（MI+ 组）与增强常规护理（对照组）相比，针对酒精使用和艾滋病毒结果的效果。我们将招募年龄在 18-49 岁之间、主要伴侣关系至少 6 个月、至少有一名伴侣报告有危险饮酒行为且已接受抗逆转录病毒治疗 6 个月的异性恋夫妇。MI 组的所有参与者都将参加三次手册式咨询课程，而 MI+ 组的参与者将使用移动呼气酒精测试器实时获得血液酒精浓度水平的反馈。随机分配到对照组的夫妇将根据南非抗逆转录病毒治疗临床指南获得增强常规护理。可行性和可接受性指标将通过描述性分析进行评估，并通过考虑时间点和治疗臂的回归模型来检验探索性假设。