Implementation of two alcohol reduction interventions among persons with hazardous alcohol use who are living with HIV in Thai Nguyen, Vietnam: a micro-costing analysis

Blackburn, Natalie A.; Go, Vivian F.; Bui, Quynh; Hutton, Heidi E.; Tampi, Radhika P.; Sripaipan, Teerada; Ha, Tran Viet; Latkin, Carl A.; Golden, Shelley D.; Golin, Carol E.; Chander, Geetanjali; Frangakis, Constantine; Gottfredson, Nisha C.; Dowdy, David W.

doi:10.1080/16549716.2020.1814035

Cited by 8 publications

(8 citation statements)

References 26 publications

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“…By integrating into an existing structure and enrolling current ART clients, we had the opportunity to evaluate the interventions in real-world clinic settings to directly inform future scale-up. 37 The role of counselors can likely be fulfilled by peers, social workers, counselors, or clinicians. The counselor role did not require a high level of education, and some counselors did not have a bachelor’s degree.…”

Section: Discussionmentioning

confidence: 99%

“…Both interventions were conducted in the very clinic settings in which they could be implemented during scale-up. By integrating into an existing structure and enrolling current ART clients, we had the opportunity to evaluate the interventions in real-world clinic settings to directly inform future scale-up . The role of counselors can likely be fulfilled by peers, social workers, counselors, or clinicians.…”

Section: Discussionmentioning

confidence: 99%

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Effect of 2 Integrated Interventions on Alcohol Abstinence and Viral Suppression Among Vietnamese Adults With Hazardous Alcohol Use and HIV

Hutton

et al. 2020

JAMA Netw Open

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Key Points Question What is the effect of 2 clinic-based behavioral interventions of varying intensity on alcohol use and viral suppression among individuals with HIV and hazardous alcohol use? Findings In this 3-group randomized clinical trial involving 440 participants, the combined intervention and brief intervention, which both incorporated motivational enhancement therapy and cognitive behavioral therapy, significantly increased the percentage of days abstinent from alcohol at 12 months compared with the standard of care. Viral suppression at 12 months was significantly higher after the brief intervention than standard of care but not significantly higher after the combined intervention than standard of care. Meaning These findings support the use of the brief intervention in antiretroviral therapy clinics to reduce alcohol use and increase viral suppression in this high-risk population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effect of 2 Integrated Interventions on Alcohol Abstinence and Viral Suppression Among Vietnamese Adults With Hazardous Alcohol Use and HIV

Hutton

et al. 2020

JAMA Netw Open

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“…A Screening, Brief Intervention, and Referral to Treatment (SBIRT) model is often employed, delivered individually or in groups. [49][50][51] Such interventions can include motivational interviewing, motivational enhancement therapy and cognitive behavioural therapy, 50,[52][53][54][55][56][57][58] often delivered by physicians or nurses and combined with pharmaceutical support. 59,60 However, they can also be delivered by other staff, including social workers, mental health workers, and physicians assistants.…”

Section: Integration Of Sud Services At Hiv Care Sitesmentioning

confidence: 99%

“…Given that many interventions include a counselling component, both scarce private space for sensitive discussions and the absence of common space for group therapy modalities, limit the type of integrated care provided. 50 Similarly, interoperable information systems that permit the flow of patient data across care interfaces is crucial to supporting integrated care and onward referra. 92 Ideally, such systems would link both health and social care services to better meet the needs of people receiving care.…”

Section: Barriers and Facilitators To Integrated Hiv And Sud Carementioning

confidence: 99%

Integrating HIV and substance misuse services: a person-centred approach grounded in human rights

Haldane

Jung

Foo

et al. 2022

The Lancet Psychiatry

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“…Among people with HIV in SSA, meta-analyses have found the pooled prevalence of alcohol use disorder, defined as problem drinking that is at risk of becoming severe [18], to be 22.9% to 29.8% [19,20]. Brief interventions to reduce alcohol use have shown efficacy in reducing drinking by 15% to 30% one year after the intervention, as well as good feasibility and cost-effectiveness in primary care settings worldwide [21][22][23][24][25][26][27][28]. However, the usefulness of brief alcohol interventions depends on effective screening for unhealthy alcohol use [23,[29][30][31][32][33][34][35][36][37][38][39][40], which is often underreported [41][42][43][44].…”

Section: Introductionmentioning

confidence: 99%

Digital Health Screening in People With HIV in Uganda to Increase Alcohol Use Reporting: Qualitative Study on the Development and Testing of the Self-administered Digital Screener for Health

Emenyonu¹,

Kekibiina²,

Woolf‐King³

et al. 2022

JMIR Form Res

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Background Alcohol consumption is a critical driver of the HIV epidemic worldwide, particularly in sub-Saharan Africa, where unhealthy alcohol use and HIV are prevalent. Brief alcohol interventions are effective in reducing alcohol use; however, they depend on effective screening for unhealthy alcohol use, which is often underreported. Thus, there is a need to develop methods to improve reporting of unhealthy alcohol use as an essential step toward referral to brief alcohol interventions. Self-administered digital health screeners may improve reporting. Objective This study aimed to develop and test a digital, easy-to-use self-administered health screener. The health screener was designed to be implemented in a busy, underresourced HIV treatment setting and used by patients with varying levels of literacy. Methods We conducted a qualitative study at the Immune Suppression Syndrome (ISS) Clinic of Mbarara Regional Referral Hospital in Uganda to develop and test a digital self-administered health screener. The health screener included a training module and assessed behaviors regarding general health, HIV care, and mental health as well as sensitive topics such as alcohol use and sexual health. We conducted focus group discussions with clinicians and patients with HIV of the Mbarara ISS Clinic who consumed alcohol to obtain input on the need for and content, format, and feasibility of the proposed screener. We iteratively revised a tablet-based screener with a subset of these participants, piloted the revised screener, and conducted individual semistructured in-depth interviews with 20 participants who had taken part in our previous studies on alcohol and HIV, including those who had previously underreported alcohol use and with low literacy. Results A total of 45 people (n=5, 11% clinicians and n=40, 89% Mbarara ISS Clinic patients) participated in the study. Of the patient participants, 65% (26/40) were male, 43% (17/40) had low literacy, and all (40/40, 100%) had self-reported alcohol use in previous studies. Clinicians and patients cited benefits such as time savings, easing of staff burden, mitigation of patient-provider tension around sensitive issues, and information communication, but also identified areas of training required, issues of security of the device, and confidentiality concerns. Patients also stated fear of forgetting how to use the tablet, making mistakes, and losing information as barriers to uptake. In pilot tests of the prototype, patients liked the feature of a recorded voice in the local language and found the screener easy to use, although many required additional help and training from the study staff to complete the screener. Conclusions We found a self-administered digital health screener to be appealing to patients and clinicians and usable in a busy HIV clinic setting, albeit with concerns about confidentiality and training. Such a screener may be useful in improving reporting of unhealthy alcohol use for referral to interventions.

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Implementation of two alcohol reduction interventions among persons with hazardous alcohol use who are living with HIV in Thai Nguyen, Vietnam: a micro-costing analysis

Cited by 8 publications

References 26 publications

Effect of 2 Integrated Interventions on Alcohol Abstinence and Viral Suppression Among Vietnamese Adults With Hazardous Alcohol Use and HIV

Effect of 2 Integrated Interventions on Alcohol Abstinence and Viral Suppression Among Vietnamese Adults With Hazardous Alcohol Use and HIV

Integrating HIV and substance misuse services: a person-centred approach grounded in human rights

Digital Health Screening in People With HIV in Uganda to Increase Alcohol Use Reporting: Qualitative Study on the Development and Testing of the Self-administered Digital Screener for Health

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