Computerized Brief Alcohol Intervention (BI) for Binge Drinking HIV At-Risk and Infected Women
| Status: | Completed |
|---|---|
| Conditions: | HIV / AIDS, Psychiatric |
| Therapuetic Areas: | Immunology / Infectious Diseases, Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 90 |
| Updated: | 3/30/2019 |
| Start Date: | October 2011 |
| End Date: | June 7, 2016 |
Computerized BI for Binge Drinking HIV At-Risk and Infected African-American Women
African American (AA) women are disproportionately affected by HIV/AIDs. The major risk
factor for HIV acquisition among AA women is high-risk heterosexual sex, including
unprotected vaginal and anal sex, and sex with a high-risk partner. Hazardous alcohol use has
been associated with high risk sexual behaviors and prevalent gonorrhea among women attending
an urban STI clinic, both of which increase a woman's vulnerability to HIV acquisition and
transmission. This application proposes a randomized controlled trial (RCT) of a culturally
tailored computer-directed brief alcohol intervention (CBI) enhanced with cell-phone booster
calls using interactive voice response technology (IVR) and text messages among HIV-infected
and at-risk AA women attending an urban STI Clinic. Hazardous drinking AA women (N=450)
presenting with STI complaints will be randomized to one of three arms: 1) usual clinical
care, 2) clinic-based, CBI, or 3) clinic-based, CBI + 3 booster calls using IVR and text
messages. The CBI, an evidence-based based method for behavior change, will use principles of
motivational interviewing, to counsel on: 1) alcohol use and 2) associated HIV/STI risk
behaviors. Primary outcomes, measured at 3, 6, and 12 month intervals, include
alcohol-related risk behaviors (number of binge drinking episodes, drinking days/week, and
drinks per occasion), sexual risk behaviors (number of partners, episodes of unprotected
vaginal/anal sex, episodes of sex while high), and occurrence of HIV/STI biomarkers. Prior to
implementing the RCT, the CBI and IVR software messages will be revised to: 1) include the
association between hazardous alcohol use and risky sexual behaviors, and 2) ensure their
relevance and acceptability using quantitative/qualitative feedback from a sample of AA women
attending a Baltimore City STI clinic. The proposed research focuses on a particularly
vulnerable population of urban HIV at-risk and HIV-infected AA women seeking treatment in a
public STI clinic and examines two novel BI intervention delivery strategies specifically
tailored to be culturally/socially relevant to this minority population. If the
intervention(s) prove to be effective, study findings will offer "real life" specialty care
clinics a screening and intervention package that is practical, low cost, and easy to
implement.
factor for HIV acquisition among AA women is high-risk heterosexual sex, including
unprotected vaginal and anal sex, and sex with a high-risk partner. Hazardous alcohol use has
been associated with high risk sexual behaviors and prevalent gonorrhea among women attending
an urban STI clinic, both of which increase a woman's vulnerability to HIV acquisition and
transmission. This application proposes a randomized controlled trial (RCT) of a culturally
tailored computer-directed brief alcohol intervention (CBI) enhanced with cell-phone booster
calls using interactive voice response technology (IVR) and text messages among HIV-infected
and at-risk AA women attending an urban STI Clinic. Hazardous drinking AA women (N=450)
presenting with STI complaints will be randomized to one of three arms: 1) usual clinical
care, 2) clinic-based, CBI, or 3) clinic-based, CBI + 3 booster calls using IVR and text
messages. The CBI, an evidence-based based method for behavior change, will use principles of
motivational interviewing, to counsel on: 1) alcohol use and 2) associated HIV/STI risk
behaviors. Primary outcomes, measured at 3, 6, and 12 month intervals, include
alcohol-related risk behaviors (number of binge drinking episodes, drinking days/week, and
drinks per occasion), sexual risk behaviors (number of partners, episodes of unprotected
vaginal/anal sex, episodes of sex while high), and occurrence of HIV/STI biomarkers. Prior to
implementing the RCT, the CBI and IVR software messages will be revised to: 1) include the
association between hazardous alcohol use and risky sexual behaviors, and 2) ensure their
relevance and acceptability using quantitative/qualitative feedback from a sample of AA women
attending a Baltimore City STI clinic. The proposed research focuses on a particularly
vulnerable population of urban HIV at-risk and HIV-infected AA women seeking treatment in a
public STI clinic and examines two novel BI intervention delivery strategies specifically
tailored to be culturally/socially relevant to this minority population. If the
intervention(s) prove to be effective, study findings will offer "real life" specialty care
clinics a screening and intervention package that is practical, low cost, and easy to
implement.
Inclusion Criteria:
1. 18 years of age or older;
2. HIV infected or HIV negative and attending the Baltimore City Health Department
sexually transmitted infection clinic for STI-related services
3. Consumes an average of 8 or more drinks per week OR has had two binge drinking
episodes (4 drinks/occasion) in the last 3 months
4. sexually active
5. Cognitively able to understand proposed research design (10 min screening, followed by
random assignment to one of three study groups (if individual fulfills criteria for
RCT enrollment);
6. Able to speak and understand English
7. Able and willing to receive text messages
Exclusion Criteria:
1. Pregnant women will be excluded and referred directly to social work for referral to
either alcohol or drug treatment due to ethical concerns of randomization to usual
care.
2. Currently enrolled in alcohol or drug treatment.
3. Non-English Speaking.
4. Actively Psychotic or have other severe mental health symptoms that would prevent
appropriate participation in the brief intervention protocol.
5. Planning on moving out of the area within 12 months of study entry
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