Conroy Amy A, Butterfield Rita M, Chibi Buyisile, Hahn Judith A, Neilands Torsten B, Msimango Lindani, van Heerden Alastair, Humphries Hilton, Starks Tyrel J
Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Center for AIDS Prevention Studies, University of California San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA, USA.
AIDS Behav. 2025 Jun 24. doi: 10.1007/s10461-025-04804-w.
We evaluated the feasibility, acceptability, and preliminary efficacy of couples motivational interviewing (MI) with and without mobile breathalyzers (Masibambisane) to reduce unhealthy alcohol use among couples with HIV in KwaZulu-Natal, South Africa. Ninety couples were randomized to couples MI with breathalyzers (MI-plus), couples MI without breathalyzers (MI-only), or enhanced usual care (EUC). Eligible couples had at least one partner on antiretroviral therapy (ART) with a positive AUDIT-C screen. Primary outcomes included retention, session attendance, breathalyzer completion, and satisfaction rates. Exploratory outcomes were unhealthy alcohol use (i.e., positive AUDIT-C screen and/or phosphatidylethanol [PEth] ≥ 35 ng/ml), number of drinking days in past month, AUDIT-C score, optimal adherence to ART (95% or higher), and viral suppression. Retention and attendance rates were 97.7% and 83.3% at 6-months. Breathalyzer completion was limited (58.2%) due to cellular and power challenges. Satisfaction exceeded 94.8%. MI-only and MI-plus arms had larger declines in drinking days and AUDIT-C score and larger increases in ART adherence vs. EUC. We observed no differences in biomarker-confirmed unhealthy alcohol use, which remained high across all arms at two months (94.6%, 96.5%, and 100%) for EUC, MI-only, and MI-plus. Viral suppression rates were 86.7%, 96.5%, and 86.2% for EUC, MI-only, and MI-plus. Between-arm differences for outcomes were non-significant; however, moderation analysis revealed that MI-only (p < 0.001) and MI-plus (p < 0.016) significantly reduced AUDIT-C scores for those with severe drinking (AUDIT-C > 7). Masibambisane was highly feasible and acceptable. Results provide initial evidence of couples MI with breathalyzers to reduce alcohol use among those with very high-risk drinking.
我们评估了在南非夸祖鲁 - 纳塔尔省，使用和不使用移动酒精检测仪（Masibambisane）的夫妻动机性访谈（MI）对于减少感染艾滋病毒夫妻的不健康饮酒行为的可行性、可接受性和初步疗效。90对夫妻被随机分为三组：使用酒精检测仪的夫妻MI组（MI-plus）、不使用酒精检测仪的夫妻MI组（MI-only）或强化常规护理组（EUC）。符合条件的夫妻中至少有一方正在接受抗逆转录病毒治疗（ART）且AUDIT-C筛查呈阳性。主要结局包括留存率、参加疗程率、酒精检测仪完成率和满意度。探索性结局包括不健康饮酒行为（即AUDIT-C筛查呈阳性和/或磷脂酰乙醇[PEth]≥35 ng/ml）、过去一个月的饮酒天数、AUDIT-C评分、对ART的最佳依从性（95%或更高）以及病毒抑制情况。6个月时的留存率和参加疗程率分别为97.7%和83.3%。由于手机信号和电力问题，酒精检测仪的完成率有限（58.2%）。满意度超过94.8%。与EUC组相比，MI-only组和MI-plus组的饮酒天数和AUDIT-C评分下降幅度更大，ART依从性提高幅度更大。我们观察到生物标志物确认的不健康饮酒行为在各组之间没有差异，在两个月时，EUC组、MI-only组和MI-plus组的这一比例仍然很高（分别为94.6%、96.5%和100%）。EUC组、MI-only组和MI-plus组的病毒抑制率分别为86.7%、96.5%和86.2%。各组之间结局的差异不显著；然而，调节分析显示，MI-only组（p < 0.001）和MI-plus组（p <
