A low-cost, sustainable intervention for drinking reduction in the HIV primary care setting

Abstract

Excess drinking poses multiple substantial health risks to HIV-infected individuals. However, no published intervention studies have focused on drinking reduction as the main outcome in HIV primary care patients. An intervention in this setting must place minimal demands on pressured staff and resources. This pilot study tested such an intervention, which consisted of brief Motivational Interviewing (MI) and HealthCall, an automated daily telephone self-monitoring system based on Interactive Voice Response (IVR), designed to extend and enhance the effects of brief MI. Thirty-one patients entered the study, received a 30-minute MI and were instructed in daily use of the IVR system. They received graphical feedback on their daily drinking from the HealthCall database after 30 days. A statistically significant decrease in drinking was found over time, both as reported in daily IVR calls (β = − 0.01, se 0.01, p=.03) and in follow-up interviews (β = − 0.04, se 0.12, p=.02) at 60 days. The proportion of daily calls made supported the feasibility of the intervention. The results indicate that HealthCall is acceptable to a disadvantaged HIV patient population, and preliminary data support the efficacy of this intervention in reducing harmful drinking among HIV primary care patients.

Acknowledgments

Support is acknowledged from NIAAA grants K05 AA014223, and from the New York State Psychiatric Institute. The authors wish to thank Valerie Richmond, M.A., for editorial assistance and manuscript preparation, and also Jesus Aquais and Daisy Sotto-Copola, R.N., for their excellent work with the patients. We also thank the two anonymous reviewers for helpful comments.