Parry, Charles D.H.Myers, BronwynLondani, MukhethwaShuper, Paul A.Janse van Rensburg, C.Manda, S.O.M. (Samuel)Nkosi, SebenzileKekwaletswe, Connie T.Hahn, Judith A.Rehm, JurgenSorsdahl, KatherineMorojele, Neo K.2024-01-242024-01-242023-11Parry, C.D.H., Myers, B., Londani, M., Shuper, P.A., Janse van Rensburg, C., Manda, S.O.M., et al. Motivational interviewing and problem-solving therapy intervention for patients on antiretroviral therapy for HIV in Tshwane, South Africa: A randomized controlled trial to assess the impact on alcohol consumption. Addiction. 2023;118(11): 2164–76. https://doi.org/10.1111/add.16278.0965-2140 (print)1360-0443 (online)10.1111/add.16278http://hdl.handle.net/2263/94078DATA AVAILABILITY STATEMENT : The data that support the findings of this study are available from the corresponding author upon reasonable request.SUPPLEMENTARY MATERIAL 1: APPENDIX S1. TABLE S1: List of randomized controlled trials (RCTs) that have evaluated the efficacy of non-specialist health worker-delivered interventions to reduce alcohol use among PLHIV. TABLE S2: Modifications to protocol. TABLE S3: Intervention Package. TABLE S4: Imputed longitudinal GEE models comparing intervention (MI/PST) to control (Overall) for Method 2. TABLE S5: Imputed longitudinal GEE models comparing intervention (MI/PST) to control (Overall) (AUDIT≥8) for Method 2.SUPPLEMENTARY MATERIAL 2 : APPENDIX S2. Supporting Information.BACKGROUND AND AIMS : Reduction of alcohol consumption is important for people undergoing treatment for HIV. We tested the efficacy of a brief intervention for reducing the average volume of alcohol consumed among patients on HIV antiretroviral therapy (ART). DESIGN, SETTING AND PARTICIPANTS : This study used a two-arm multi-centre randomized controlled trial with follow-up to 6 months. Recruitment occurred between May 2016 and October 2017 at six ART clinics at public hospitals in Tshwane, South Africa. Participants were people living with HIV, mean age 40.8 years [standard deviation (SD) = 9.07], 57.5% female, and on average 6.9 years (SD = 3.62) on ART. At baseline (BL), the mean number of drinks consumed over the past 30 days was 25.2 (SD = 38.3). Of 756 eligible patients, 623 were enrolled. INTERVENTION : Participants were randomly assigned to a motivational interviewing (MI)/problem-solving therapy (PST) intervention arm (four modules of MI and PST delivered over two sessions by interventionists) or a treatment as usual (TAU) comparison arm. People assessing outcomes were masked to group assignment. MEASUREMENTS : The primary outcome was the number of standard drinks (15 ml pure alcohol) consumed during the past 30 days assessed at 6-month follow-up (6MFU). FINDINGS : Of the 305 participants randomized to MI/PST, 225 (74%) completed the intervention (all modules). At 6MFU, retention was 88% for the control and 83% for the intervention arm. In support of the hypothesis, an intention-to-treat-analysis for the primary outcome at 6MFU was −0.410 (95% confidence interval = −0.670 to −0.149) units lower on log scale in the intervention group than in the control group (P = 0.002), a 34% relative reduction in the number of drinks. Sensitivity analyses were undertaken for patients who had alcohol use disorders identification test (AUDIT) scores ≥ 8 at BL (n = 299). Findings were similar to those of the whole sample. CONCLUSIONS : In South Africa, a motivational interviewing/problem-solving therapy intervention significantly reduced drinking levels in HIV-infected patients on antiretroviral therapy at 6-month follow-up.en© 2023 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License.Antiretroviral therapy (ART)South Africa (SA)Problem-solving therapyPeople living with HIV (PLHIV)Human immunodeficiency virus (HIV)Brief interventionAlcoholSDG-03: Good health and well-beingArticle