Combining Rapid HIV Testing and a Brief Alcohol Intervention in Young Unhealthy Drinkers in the Emergency Department: A Pilot Study

Abstract

Background: We sought to determine the feasibility and impact of brief alcohol/ sexual risk reduction counseling with rapid HIV testing in the emergency department (ED). Methods: We recruited 18–40 year olds with unhealthy alcohol use, sexual risk behaviors, and negative/unknown HIV status and assessed for differences in their alcohol consumption and sexual risk behaviors at baseline versus 2 months. Results: Participants (n = 85) were 61% male, mean age 26 years old, 59% white, 92% unmarried, 57% college educated, 45% without a regular doctor, and 80% with an Alcohol Use Disorders Identification Test (AUDIT) score ≥8. All rapid HIV tests were negative. Among the 70 (82%) with follow-up, alcohol consumption decreased with fewer average weekly drinks (23.6 vs. 9.8, p = .003) and binge drinking episodes (2.0 vs. .9, p = .012). Post-intervention, sexual risk decreased, including increased condom use (23% vs. 46%, p = .007). Women had a greater decrease in alcohol use prior to sex compared with men (p = .021 for interaction). Conclusions: Alcohol/sexual risk reduction counseling with HIV testing in the ED is feasible and potentially effective for reducing alcohol use and sexual risk behaviors among young unhealthy drinkers. Scientific Significance: Future randomized controlled trials are warranted to assess efficacy of this intervention, which would provide young at-risk populations with important preventive services, which they may not have access to otherwise.

• HIV
• alcohol drinking
• emergency medicine
• counseling
• unsafe sex

ACKNOWLEDGMENTS

This work was generously supported by Yale University’s Center for Interdisciplinary Research on AIDS (CIRA) through a grant from the National Institute of Mental Health to Paul Cleary, Ph.D. (No. P30 MH 62294). The sponsor was not involved in the study design, collection, analysis, interpretation of data, in the writing of the report, or in the decision to submit the article for publication.

E. Jennifer Edelman is supported by the Robert Wood Johnson Foundation Clinical Scholars Program and the US Department of Veteran Affairs. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.

We thank Dr. Michael Pantalon, who kindly assisted with the development and training of the counseling intervention, and Ms. Patti Owens for her generous assistance in conducting the study.

This research was presented as an oral presentation at the Yale Center for Interdisciplinary Research on AIDS (CIRA) AIDS Science Day on 23 March 2011, New Haven, CT, USA, and as a poster presentation at the Society for General Internal Medicine 34th National Annual Meeting, 6 May 2011, Phoenix, AZ, USA, and the INEBRIA 8th Annual Meeting, 22 September Boston, MA, USA.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Notice of Correction

The version of this article published online ahead of print on 16 Jul 2012 contained an error on page 3 Table 2. The heading ‘How often to use condom, % (n) .007’ was wrongfully removed from the table. This has now been corrected. Also, within the abstract “>9” has been corrected to “≥8” and within table 1 “8+” and “20+” has been changed to “≥8” and “≥20”.