A randomized clinical trial of a group cognitive–behavioral therapy to reduce alcohol use among human immunodeficiency virus‐infected outpatients in western Kenya
Background and aims Culturally relevant and feasible interventions are needed to address limited professional resources in sub‐Saharan Africa for behaviorally treating the dual epidemics of HIV and alcohol use disorder. This study tested the efficacy of a cognitive–behavioral therapy (CBT) intervent...
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Veröffentlicht in: | Addiction (Abingdon, England) England), 2021-02, Vol.116 (2), p.305-318 |
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creator | Papas, Rebecca K. Gakinya, Benson N. Mwaniki, Michael M. Lee, Hana Keter, Alfred K. Martino, Steve Klein, Debra A. Liu, Tao Loxley, Michelle P. Sidle, John E. Schlaudt, Kathryn Nafula, Tobista Omodi, Victor M. Baliddawa, Joyce B. Kinyanjui, Daniel W. Maisto, Stephen A. |
description | Background and aims
Culturally relevant and feasible interventions are needed to address limited professional resources in sub‐Saharan Africa for behaviorally treating the dual epidemics of HIV and alcohol use disorder. This study tested the efficacy of a cognitive–behavioral therapy (CBT) intervention to reduce alcohol use among HIV‐infected outpatients in Eldoret, Kenya.
Design
Randomized clinical trial.
Setting
A large HIV outpatient clinic in Eldoret, Kenya, affiliated with the Academic Model Providing Access to Healthcare collaboration.
Participants
A total of 614 HIV‐infected outpatients [312 CBT; 302 healthy life‐styles (HL); 48.5% male; mean age: 38.9 years; mean education 7.7 years] who reported a minimum of hazardous or binge drinking.
Intervention and comparator
A culturally adapted six‐session gender‐stratified group CBT intervention compared with HL education, each delivered by paraprofessionals over six weekly 90‐minute sessions with a 9‐month follow‐up.
Measurements
Primary outcome measures were percentage of drinking days (PDD) and mean drinks per drinking day (DDD) computed from retrospective daily number of drinks data obtained by use of the time‐line follow‐back from baseline to 9 months post‐intervention. Exploratory analyses examined unprotected sex and number of partners.
Findings
Median attendance was six sessions across condition. Retention at 9 months post‐intervention was high and similar by condition: CBT 86% and HL 83%. PDD and DDD marginal means were significantly lower in CBT than HL at all three study phases. Maintenance period, PDD – CBT = 3.64 (0.696), HL = 5.72 (0.71), mean difference 2.08, 95% confidence interval (CI) = 0.13 – 4.04; DDD – CBT = 0.66 (0.96), HL = 0.98 (0.098), mean difference = 0.31, 95% CI = 0.05 – 0.58. Risky sex decreased over time in both conditions, with a temporary effect for CBT at the 1‐month follow‐up.
Conclusions
A cognitive–behavioral therapy intervention was more efficacious than healthy lifestyles education in reducing alcohol use among HIV‐infected Kenyan outpatient drinkers. |
doi_str_mv | 10.1111/add.15112 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2404637942</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2404637942</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3882-a028019bebd16091eaac767ab626b1cd373964ff60161c2f04ac18cb0060664f3</originalsourceid><addsrcrecordid>eNp10U1u1DAYBmALUdGhsOACyBIbWKT13zjOctTyp1ZiA-vIsb_MuErsYMdThVWPgMQdOFhPgssUFkh4YVvyo9ef9CL0gpJTWtaZtvaUrillj9CKckkqIgR_jFakkeuKUUGO0dOUrgkhtWrEE3TMmWBMqvUK_dzgqL0No_sGFpvBeWf0gOfoyh56rPE2hjxhE7bezW4Pd7c_OtjpvQvx3u0g6mnBc8ARbDaA9WDCLgw4p3Ifg9_iXR61x24csw8WemcceLPgvYs53d1-d74HM5fPQ54nPZfHOWHn8Q2kGaLHl-AX_Qwd9XpI8PzhPEFf3r39fP6huvr0_uP55qoyXClWacIUoU0HnaWSNBS0NrWsdSeZ7KixvOaNFH0vCZXUsJ4IbagyHSGSyPLAT9DrQ-4Uw9dcJmhHlwwMg_YQcmqZIELyuhGs0Ff_0OuQoy_TFVWrWnElm6LeHJSJIaUIfTtFN-q4tJS09-W1pbz2d3nFvnxIzN0I9q_801YBZwdw4wZY_p_Ubi4uDpG_AHk4qA8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2478783869</pqid></control><display><type>article</type><title>A randomized clinical trial of a group cognitive–behavioral therapy to reduce alcohol use among human immunodeficiency virus‐infected outpatients in western Kenya</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Papas, Rebecca K. ; Gakinya, Benson N. ; Mwaniki, Michael M. ; Lee, Hana ; Keter, Alfred K. ; Martino, Steve ; Klein, Debra A. ; Liu, Tao ; Loxley, Michelle P. ; Sidle, John E. ; Schlaudt, Kathryn ; Nafula, Tobista ; Omodi, Victor M. ; Baliddawa, Joyce B. ; Kinyanjui, Daniel W. ; Maisto, Stephen A.</creator><creatorcontrib>Papas, Rebecca K. ; Gakinya, Benson N. ; Mwaniki, Michael M. ; Lee, Hana ; Keter, Alfred K. ; Martino, Steve ; Klein, Debra A. ; Liu, Tao ; Loxley, Michelle P. ; Sidle, John E. ; Schlaudt, Kathryn ; Nafula, Tobista ; Omodi, Victor M. ; Baliddawa, Joyce B. ; Kinyanjui, Daniel W. ; Maisto, Stephen A.</creatorcontrib><description>Background and aims
Culturally relevant and feasible interventions are needed to address limited professional resources in sub‐Saharan Africa for behaviorally treating the dual epidemics of HIV and alcohol use disorder. This study tested the efficacy of a cognitive–behavioral therapy (CBT) intervention to reduce alcohol use among HIV‐infected outpatients in Eldoret, Kenya.
Design
Randomized clinical trial.
Setting
A large HIV outpatient clinic in Eldoret, Kenya, affiliated with the Academic Model Providing Access to Healthcare collaboration.
Participants
A total of 614 HIV‐infected outpatients [312 CBT; 302 healthy life‐styles (HL); 48.5% male; mean age: 38.9 years; mean education 7.7 years] who reported a minimum of hazardous or binge drinking.
Intervention and comparator
A culturally adapted six‐session gender‐stratified group CBT intervention compared with HL education, each delivered by paraprofessionals over six weekly 90‐minute sessions with a 9‐month follow‐up.
Measurements
Primary outcome measures were percentage of drinking days (PDD) and mean drinks per drinking day (DDD) computed from retrospective daily number of drinks data obtained by use of the time‐line follow‐back from baseline to 9 months post‐intervention. Exploratory analyses examined unprotected sex and number of partners.
Findings
Median attendance was six sessions across condition. Retention at 9 months post‐intervention was high and similar by condition: CBT 86% and HL 83%. PDD and DDD marginal means were significantly lower in CBT than HL at all three study phases. Maintenance period, PDD – CBT = 3.64 (0.696), HL = 5.72 (0.71), mean difference 2.08, 95% confidence interval (CI) = 0.13 – 4.04; DDD – CBT = 0.66 (0.96), HL = 0.98 (0.098), mean difference = 0.31, 95% CI = 0.05 – 0.58. Risky sex decreased over time in both conditions, with a temporary effect for CBT at the 1‐month follow‐up.
Conclusions
A cognitive–behavioral therapy intervention was more efficacious than healthy lifestyles education in reducing alcohol use among HIV‐infected Kenyan outpatient drinkers.</description><identifier>ISSN: 0965-2140</identifier><identifier>EISSN: 1360-0443</identifier><identifier>DOI: 10.1111/add.15112</identifier><identifier>PMID: 32422685</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Alcohol ; Alcohol Drinking - epidemiology ; Alcohol related disorders ; Alcohol use ; Alcoholic beverages ; Alcoholism ; Alcoholism - therapy ; Behavior modification ; Clinical research ; Clinical trials ; Cognitive ability ; Cognitive behavioral therapy ; Cognitive Behavioral Therapy - methods ; Cognitive therapy ; Cognitive-behavioral factors ; Drinking behavior ; Drinks ; Efficacy ; Epidemics ; Female ; Group therapy ; Health care access ; HIV ; HIV Infections - complications ; Human immunodeficiency virus ; Humans ; Intervention ; Kenya ; Kenya - epidemiology ; Male ; Middle Aged ; Outpatients ; paraprofessional ; Paraprofessionals ; randomized clinical trial ; Safe sexual practices ; Sexual behavior ; Treatment Outcome</subject><ispartof>Addiction (Abingdon, England), 2021-02, Vol.116 (2), p.305-318</ispartof><rights>2020 Society for the Study of Addiction</rights><rights>2020 Society for the Study of Addiction.</rights><rights>2021 Society for the Study of Addiction</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3882-a028019bebd16091eaac767ab626b1cd373964ff60161c2f04ac18cb0060664f3</citedby><cites>FETCH-LOGICAL-c3882-a028019bebd16091eaac767ab626b1cd373964ff60161c2f04ac18cb0060664f3</cites><orcidid>0000-0001-6987-4679</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fadd.15112$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fadd.15112$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32422685$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Papas, Rebecca K.</creatorcontrib><creatorcontrib>Gakinya, Benson N.</creatorcontrib><creatorcontrib>Mwaniki, Michael M.</creatorcontrib><creatorcontrib>Lee, Hana</creatorcontrib><creatorcontrib>Keter, Alfred K.</creatorcontrib><creatorcontrib>Martino, Steve</creatorcontrib><creatorcontrib>Klein, Debra A.</creatorcontrib><creatorcontrib>Liu, Tao</creatorcontrib><creatorcontrib>Loxley, Michelle P.</creatorcontrib><creatorcontrib>Sidle, John E.</creatorcontrib><creatorcontrib>Schlaudt, Kathryn</creatorcontrib><creatorcontrib>Nafula, Tobista</creatorcontrib><creatorcontrib>Omodi, Victor M.</creatorcontrib><creatorcontrib>Baliddawa, Joyce B.</creatorcontrib><creatorcontrib>Kinyanjui, Daniel W.</creatorcontrib><creatorcontrib>Maisto, Stephen A.</creatorcontrib><title>A randomized clinical trial of a group cognitive–behavioral therapy to reduce alcohol use among human immunodeficiency virus‐infected outpatients in western Kenya</title><title>Addiction (Abingdon, England)</title><addtitle>Addiction</addtitle><description>Background and aims
Culturally relevant and feasible interventions are needed to address limited professional resources in sub‐Saharan Africa for behaviorally treating the dual epidemics of HIV and alcohol use disorder. This study tested the efficacy of a cognitive–behavioral therapy (CBT) intervention to reduce alcohol use among HIV‐infected outpatients in Eldoret, Kenya.
Design
Randomized clinical trial.
Setting
A large HIV outpatient clinic in Eldoret, Kenya, affiliated with the Academic Model Providing Access to Healthcare collaboration.
Participants
A total of 614 HIV‐infected outpatients [312 CBT; 302 healthy life‐styles (HL); 48.5% male; mean age: 38.9 years; mean education 7.7 years] who reported a minimum of hazardous or binge drinking.
Intervention and comparator
A culturally adapted six‐session gender‐stratified group CBT intervention compared with HL education, each delivered by paraprofessionals over six weekly 90‐minute sessions with a 9‐month follow‐up.
Measurements
Primary outcome measures were percentage of drinking days (PDD) and mean drinks per drinking day (DDD) computed from retrospective daily number of drinks data obtained by use of the time‐line follow‐back from baseline to 9 months post‐intervention. Exploratory analyses examined unprotected sex and number of partners.
Findings
Median attendance was six sessions across condition. Retention at 9 months post‐intervention was high and similar by condition: CBT 86% and HL 83%. PDD and DDD marginal means were significantly lower in CBT than HL at all three study phases. Maintenance period, PDD – CBT = 3.64 (0.696), HL = 5.72 (0.71), mean difference 2.08, 95% confidence interval (CI) = 0.13 – 4.04; DDD – CBT = 0.66 (0.96), HL = 0.98 (0.098), mean difference = 0.31, 95% CI = 0.05 – 0.58. Risky sex decreased over time in both conditions, with a temporary effect for CBT at the 1‐month follow‐up.
Conclusions
A cognitive–behavioral therapy intervention was more efficacious than healthy lifestyles education in reducing alcohol use among HIV‐infected Kenyan outpatient drinkers.</description><subject>Adult</subject><subject>Alcohol</subject><subject>Alcohol Drinking - epidemiology</subject><subject>Alcohol related disorders</subject><subject>Alcohol use</subject><subject>Alcoholic beverages</subject><subject>Alcoholism</subject><subject>Alcoholism - therapy</subject><subject>Behavior modification</subject><subject>Clinical research</subject><subject>Clinical trials</subject><subject>Cognitive ability</subject><subject>Cognitive behavioral therapy</subject><subject>Cognitive Behavioral Therapy - methods</subject><subject>Cognitive therapy</subject><subject>Cognitive-behavioral factors</subject><subject>Drinking behavior</subject><subject>Drinks</subject><subject>Efficacy</subject><subject>Epidemics</subject><subject>Female</subject><subject>Group therapy</subject><subject>Health care access</subject><subject>HIV</subject><subject>HIV Infections - complications</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Intervention</subject><subject>Kenya</subject><subject>Kenya - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Outpatients</subject><subject>paraprofessional</subject><subject>Paraprofessionals</subject><subject>randomized clinical trial</subject><subject>Safe sexual practices</subject><subject>Sexual behavior</subject><subject>Treatment Outcome</subject><issn>0965-2140</issn><issn>1360-0443</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10U1u1DAYBmALUdGhsOACyBIbWKT13zjOctTyp1ZiA-vIsb_MuErsYMdThVWPgMQdOFhPgssUFkh4YVvyo9ef9CL0gpJTWtaZtvaUrillj9CKckkqIgR_jFakkeuKUUGO0dOUrgkhtWrEE3TMmWBMqvUK_dzgqL0No_sGFpvBeWf0gOfoyh56rPE2hjxhE7bezW4Pd7c_OtjpvQvx3u0g6mnBc8ARbDaA9WDCLgw4p3Ifg9_iXR61x24csw8WemcceLPgvYs53d1-d74HM5fPQ54nPZfHOWHn8Q2kGaLHl-AX_Qwd9XpI8PzhPEFf3r39fP6huvr0_uP55qoyXClWacIUoU0HnaWSNBS0NrWsdSeZ7KixvOaNFH0vCZXUsJ4IbagyHSGSyPLAT9DrQ-4Uw9dcJmhHlwwMg_YQcmqZIELyuhGs0Ff_0OuQoy_TFVWrWnElm6LeHJSJIaUIfTtFN-q4tJS09-W1pbz2d3nFvnxIzN0I9q_801YBZwdw4wZY_p_Ubi4uDpG_AHk4qA8</recordid><startdate>202102</startdate><enddate>202102</enddate><creator>Papas, Rebecca K.</creator><creator>Gakinya, Benson N.</creator><creator>Mwaniki, Michael M.</creator><creator>Lee, Hana</creator><creator>Keter, Alfred K.</creator><creator>Martino, Steve</creator><creator>Klein, Debra A.</creator><creator>Liu, Tao</creator><creator>Loxley, Michelle P.</creator><creator>Sidle, John E.</creator><creator>Schlaudt, Kathryn</creator><creator>Nafula, Tobista</creator><creator>Omodi, Victor M.</creator><creator>Baliddawa, Joyce B.</creator><creator>Kinyanjui, Daniel W.</creator><creator>Maisto, Stephen A.</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QG</scope><scope>7TK</scope><scope>8BJ</scope><scope>FQK</scope><scope>JBE</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6987-4679</orcidid></search><sort><creationdate>202102</creationdate><title>A randomized clinical trial of a group cognitive–behavioral therapy to reduce alcohol use among human immunodeficiency virus‐infected outpatients in western Kenya</title><author>Papas, Rebecca K. ; Gakinya, Benson N. ; Mwaniki, Michael M. ; Lee, Hana ; Keter, Alfred K. ; Martino, Steve ; Klein, Debra A. ; Liu, Tao ; Loxley, Michelle P. ; Sidle, John E. ; Schlaudt, Kathryn ; Nafula, Tobista ; Omodi, Victor M. ; Baliddawa, Joyce B. ; Kinyanjui, Daniel W. ; Maisto, Stephen A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3882-a028019bebd16091eaac767ab626b1cd373964ff60161c2f04ac18cb0060664f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Alcohol</topic><topic>Alcohol Drinking - epidemiology</topic><topic>Alcohol related disorders</topic><topic>Alcohol use</topic><topic>Alcoholic beverages</topic><topic>Alcoholism</topic><topic>Alcoholism - therapy</topic><topic>Behavior modification</topic><topic>Clinical research</topic><topic>Clinical trials</topic><topic>Cognitive ability</topic><topic>Cognitive behavioral therapy</topic><topic>Cognitive Behavioral Therapy - methods</topic><topic>Cognitive therapy</topic><topic>Cognitive-behavioral factors</topic><topic>Drinking behavior</topic><topic>Drinks</topic><topic>Efficacy</topic><topic>Epidemics</topic><topic>Female</topic><topic>Group therapy</topic><topic>Health care access</topic><topic>HIV</topic><topic>HIV Infections - complications</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Intervention</topic><topic>Kenya</topic><topic>Kenya - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Outpatients</topic><topic>paraprofessional</topic><topic>Paraprofessionals</topic><topic>randomized clinical trial</topic><topic>Safe sexual practices</topic><topic>Sexual behavior</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Papas, Rebecca K.</creatorcontrib><creatorcontrib>Gakinya, Benson N.</creatorcontrib><creatorcontrib>Mwaniki, Michael M.</creatorcontrib><creatorcontrib>Lee, Hana</creatorcontrib><creatorcontrib>Keter, Alfred K.</creatorcontrib><creatorcontrib>Martino, Steve</creatorcontrib><creatorcontrib>Klein, Debra A.</creatorcontrib><creatorcontrib>Liu, Tao</creatorcontrib><creatorcontrib>Loxley, Michelle P.</creatorcontrib><creatorcontrib>Sidle, John E.</creatorcontrib><creatorcontrib>Schlaudt, Kathryn</creatorcontrib><creatorcontrib>Nafula, Tobista</creatorcontrib><creatorcontrib>Omodi, Victor M.</creatorcontrib><creatorcontrib>Baliddawa, Joyce B.</creatorcontrib><creatorcontrib>Kinyanjui, Daniel W.</creatorcontrib><creatorcontrib>Maisto, Stephen A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Animal Behavior Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Addiction (Abingdon, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Papas, Rebecca K.</au><au>Gakinya, Benson N.</au><au>Mwaniki, Michael M.</au><au>Lee, Hana</au><au>Keter, Alfred K.</au><au>Martino, Steve</au><au>Klein, Debra A.</au><au>Liu, Tao</au><au>Loxley, Michelle P.</au><au>Sidle, John E.</au><au>Schlaudt, Kathryn</au><au>Nafula, Tobista</au><au>Omodi, Victor M.</au><au>Baliddawa, Joyce B.</au><au>Kinyanjui, Daniel W.</au><au>Maisto, Stephen A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A randomized clinical trial of a group cognitive–behavioral therapy to reduce alcohol use among human immunodeficiency virus‐infected outpatients in western Kenya</atitle><jtitle>Addiction (Abingdon, England)</jtitle><addtitle>Addiction</addtitle><date>2021-02</date><risdate>2021</risdate><volume>116</volume><issue>2</issue><spage>305</spage><epage>318</epage><pages>305-318</pages><issn>0965-2140</issn><eissn>1360-0443</eissn><abstract>Background and aims
Culturally relevant and feasible interventions are needed to address limited professional resources in sub‐Saharan Africa for behaviorally treating the dual epidemics of HIV and alcohol use disorder. This study tested the efficacy of a cognitive–behavioral therapy (CBT) intervention to reduce alcohol use among HIV‐infected outpatients in Eldoret, Kenya.
Design
Randomized clinical trial.
Setting
A large HIV outpatient clinic in Eldoret, Kenya, affiliated with the Academic Model Providing Access to Healthcare collaboration.
Participants
A total of 614 HIV‐infected outpatients [312 CBT; 302 healthy life‐styles (HL); 48.5% male; mean age: 38.9 years; mean education 7.7 years] who reported a minimum of hazardous or binge drinking.
Intervention and comparator
A culturally adapted six‐session gender‐stratified group CBT intervention compared with HL education, each delivered by paraprofessionals over six weekly 90‐minute sessions with a 9‐month follow‐up.
Measurements
Primary outcome measures were percentage of drinking days (PDD) and mean drinks per drinking day (DDD) computed from retrospective daily number of drinks data obtained by use of the time‐line follow‐back from baseline to 9 months post‐intervention. Exploratory analyses examined unprotected sex and number of partners.
Findings
Median attendance was six sessions across condition. Retention at 9 months post‐intervention was high and similar by condition: CBT 86% and HL 83%. PDD and DDD marginal means were significantly lower in CBT than HL at all three study phases. Maintenance period, PDD – CBT = 3.64 (0.696), HL = 5.72 (0.71), mean difference 2.08, 95% confidence interval (CI) = 0.13 – 4.04; DDD – CBT = 0.66 (0.96), HL = 0.98 (0.098), mean difference = 0.31, 95% CI = 0.05 – 0.58. Risky sex decreased over time in both conditions, with a temporary effect for CBT at the 1‐month follow‐up.
Conclusions
A cognitive–behavioral therapy intervention was more efficacious than healthy lifestyles education in reducing alcohol use among HIV‐infected Kenyan outpatient drinkers.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>32422685</pmid><doi>10.1111/add.15112</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0001-6987-4679</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Adult Alcohol Alcohol Drinking - epidemiology Alcohol related disorders Alcohol use Alcoholic beverages Alcoholism Alcoholism - therapy Behavior modification Clinical research Clinical trials Cognitive ability Cognitive behavioral therapy Cognitive Behavioral Therapy - methods Cognitive therapy Cognitive-behavioral factors Drinking behavior Drinks Efficacy Epidemics Female Group therapy Health care access HIV HIV Infections - complications Human immunodeficiency virus Humans Intervention Kenya Kenya - epidemiology Male Middle Aged Outpatients paraprofessional Paraprofessionals randomized clinical trial Safe sexual practices Sexual behavior Treatment Outcome |
title | A randomized clinical trial of a group cognitive–behavioral therapy to reduce alcohol use among human immunodeficiency virus‐infected outpatients in western Kenya |
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