People with HIV who drink are more likely to reduce alcohol consumption after they have undergone treatment known as integrated alcohol treatment, according to a study conducted by Yale.
This finding supports the greater use of this treatment model in HIV clinics to improve patient outcomes for HIV and beverages, researchers say.
The study was published in The Lancet HIV.
Gradual care is used to treat some patients with chronic illnesses such as hypertension and depression. This involves the use of various treatments that are "enhanced", or increased intensity over time, in response to patients' needs. Before this new study, little research was done to assess the impact of increased care for patients struggling with alcohol disturbances, and none have been implemented in HIV treatment settings, researchers say.
The research team recruited 128 people from one of the five HIV-based clinics based on veterans issues. They randomized patients into one of two groups – those who provided integrated therapy with a degree of alcohol and an equal number that received treatment as usual.
Patients with a degree of care are offered evidence based treatments, including medication, motivational therapy and specialist care in outpatient or residential care. For comparison, patients who were treated as regular patients were referred to a special VA addiction therapy at the discretion of their HIV clinician.
At the end of the study period, the researchers found that patients who received integrated stepped care were better off. After 52 weeks, patients with Stephanie had less drunken days, they drank less per day of drinks and had more days of abstinence, observers noted.
"We have seen general improvements in alcohol consumption," says Dr. Jennifer Edelman, lead author and associate professor of internal medicine. "We also found improved HIV outcomes at a 52-week rating."
Improvements in HIV status in patients are likely to be associated with reduced alcohol use, Edelman noted. "Over time, patients who received integrated care have shown a reduction in alcohol use and a higher rate of undetectable HIV viral load, probably associated with improved adherence to HIV drugs," she said.
The results of the study support the increased use of integrated, enhanced care for alcohol abuse in environments where patients are already being treated with HIV, researchers say.
David Fiellin, MSc, was the lead researcher. Other authors include Stephen Maisto, Nathan Hansen, Christopher Cutter, James Dziura, Yanhong Deng, Lynn Fiellin, Patrick O'Connor, Roger Bedimo, Cynthia Gibert, Vincent Marconi, David Rimland, Maria Rodriguez-Barradas, Michael Simberkoff, Janet Tate, Amy Justice and Kendall Bryant.
This work is supported by grants from the National Institute for the Abuse of Alcohol and Alcoholism. Edelman was supported as a scientist for drug abuse, HIV and addiction.
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