{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T18:26:49Z","timestamp":1790965609024,"version":"4.1.0"},"reference-count":57,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,12,13]],"date-time":"2020-12-13T00:00:00Z","timestamp":1607817600000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. Intern. AIDS Soc."],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>There have been very few randomized clinical trials of interventions for alcohol use disorders (AUD) in people living with HIV (PLWH) in African countries. This is despite the fact that alcohol use is one of the modifiable risk factors for poor virological control in PLWH on antiretroviral therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixteen clinic clusters in Zimbabwe were selected through stratified randomization and randomized 1: 1 to Intervention and Control arms. Inclusion criteria for individual participants were being adult, living with HIV and a probable alcohol use disorder as defined by a score of 6 (women) or 7 (men) on the Alcohol Use Disorders Identification Test (AUDIT). In the Intervention clusters, participants received 8 to 10 sessions of Motivational Interviewing blended with brief Cognitive Behavioural Therapy (MI\u2010CBT). In the control clusters, participants received four Enhanced Usual Care (EUC) sessions based on the alcohol treatment module from the World Health Organisation mhGAP intervention guide. General Nurses from the clinics were trained to deliver both treatments. The primary outcome was a change in AUDIT score at six\u2010month post\u2010randomization. Viral load, functioning and quality of life were secondary outcomes. A random\u2010effects analysis\u2010of\u2010covariance model was used to account for the cluster design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two hundred and thirty\u2010four participants (n\u00a0=\u00a0108 intervention and n\u00a0=\u00a0126 control) were enrolled across 16 clinics. Participants were recruited from November 2016 to November 2017 and followed through to May 2018. Their mean age was 43.3\u00a0years (SD\u00a0=\u00a09.1) and 78.6% (n\u00a0=\u00a0184) were male. At six months, the mean AUDIT score fell by \u22126.15 (95% CI \u22126.32; \u22126.00) in the MI\u2010CBT arm, compared to a fall of\u00a0\u2212\u00a03.09 95 % CI\u00a0\u2212\u00a03.21; \u22122.93) in the EUC arm (mean difference \u22123.09 (95% CI \u22124.53 to \u22121.23) (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.05). Viral load reduced and quality of life and functioning improved in both arms but the difference between arms was non\u2010significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Interventions for hazardous drinking and AUD comprising brief, multiple alcohol treatment sessions delivered by nurses in public HIV facilities in low\u2010income African countries can reduce problematic drinking among PLWH. Such interventions should be integrated into the primary care management of AUD and HIV and delivered by non\u2010specialist providers. Research is needed on cost\u2010effectiveness and implementation of such interventions, and on validation of cut\u2010points for alcohol use scales in low resource settings, in partnership with those with lived experience of HIV and AUD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.25641","type":"journal-article","created":{"date-parts":[[2020,12,13]],"date-time":"2020-12-13T04:03:17Z","timestamp":1607832197000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Effectiveness of a psychological intervention delivered by general nurses for alcohol use disorders in people living with HIV in Zimbabwe: a cluster randomized controlled trial"],"prefix":"10.1002","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7921-2812","authenticated-orcid":false,"given":"Munyaradzi","family":"Madhombiro","sequence":"first","affiliation":[{"name":"Department of Psychiatry University of Zimbabwe Harare Zimbabwe"},{"name":"SUNY University at Buffalo Buffalo NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Kidd","sequence":"additional","affiliation":[{"name":"Centre for Statistical Consultation Stellenbosch University Stellenbosch South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bazondlile","family":"Dube","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Zimbabwe Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Dube","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Zimbabwe Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilson","family":"Mutsvuke","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Zimbabwe Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thabani","family":"Muronzie","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Zimbabwe Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danai Tavonga","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Zimbabwe Harare Zimbabwe"},{"name":"Department of Medical Laboratory Sciences University of Zimbabwe Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Derveeuw","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology and Neuroscience King\u2019s College London London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dixon","family":"Chibanda","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Zimbabwe Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Chingono","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Zimbabwe Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simbarashe","family":"Rusakaniko","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Zimbabwe Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Hutson","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Roswell Park Comprehensive Cancer Center Buffalo NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gene D","family":"Morse","sequence":"additional","affiliation":[{"name":"SUNY University at Buffalo Buffalo NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie A","family":"Abas","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology and Neuroscience King\u2019s College London London United Kingdom"},{"name":"Lewisham Hospital South London and Maudsley NHS Foundation Trust London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soraya","family":"Seedat","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences Stellenbosch University Stellenbosch South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,13]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.13757"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001549"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27710"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12433"},{"key":"e_1_2_10_6_1","unstructured":"UNAIDS.Treatment cascade \u2010 progress towards 90\u201390\u201090 targets.2019."},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13011-019-0240-3"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25202"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000322"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2017.09.013"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2014.933769"},{"key":"e_1_2_10_12_1","unstructured":"WHO.mhGAP Intervention Guide. Mental Health Gap Action Programme. Version 2.0.2016."},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325957416649669"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2011.03518.x"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0220799"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000011688"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.15112"},{"key":"e_1_2_10_18_1","unstructured":"UNAIDS.UNAIDS 2016 Estimates.2016. [cited 2019 July 17]. Available from:http:\/\/aidsinfo.unaids.org\/"},{"key":"e_1_2_10_19_1","unstructured":"World Health Organisation.Global status report on alcohol and health 2018.2019."},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-017-1208-3"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-019-1176-4"},{"key":"e_1_2_10_22_1","first-page":"47","article-title":"Perceptions of alcohol use in the context of HIV treatment: a qualitative study","volume":"10","author":"Madhombiro M","year":"2018","journal-title":"HIV AIDS (Auckl)"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-019-0143-7"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000225730.79610.61"},{"key":"e_1_2_10_25_1","first-page":"115","article-title":"One\u2010pill once\u2010a\u2010day HAART: a simplification strategy that improves adherence and quality of life of HIV\u2010infected subjects","volume":"4","author":"Airoldi M","year":"2010","journal-title":"Patient Prefer Adherence"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-4659-z"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2002.00018.x"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.141"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.1997.58.7"},{"issue":"6","key":"e_1_2_10_30_1","first-page":"1300","article-title":"Matching alcoholism treatments to client heterogeneity: Project MATCH three\u2010year drinking outcomes","volume":"22","author":"MATCH Group","year":"1998","journal-title":"Alcohol Clin Exp Res"},{"key":"e_1_2_10_31_1","unstructured":"WHO.mhGAP Mental Health Gap Action Programme: scaling up care for mental neurological and substance use disorders.Geneva:World Health Organisation;2010."},{"key":"e_1_2_10_32_1","unstructured":"BaborTF Higgins\u2010BiddleJC SaundersJB MonetiroMG.The Alcohol Use Disorders Identification Test \u2010 Guidelines for Use in Primary Care. World Health Organization Department of Mental Health And Substance Depndence.2001; 2."},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1993.tb02093.x"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1996.tb10640.x"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12345"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1992.tb03256.x"},{"issue":"2","key":"e_1_2_10_37_1","first-page":"26","article-title":"Alcohol problems among patients attending five primary health care clinics in Harare city","volume":"39","author":"Chinyadza E","year":"1993","journal-title":"Cent Afr J Med"},{"issue":"8","key":"e_1_2_10_38_1","first-page":"226","article-title":"Prevalence of psychoactive substance use among psychiatric in\u2010patients in Harare, Zimbabwe","volume":"43","author":"Acuda SW","year":"1997","journal-title":"Cent Afr J Med"},{"issue":"10","key":"e_1_2_10_39_1","first-page":"503","article-title":"Prevalence of HIV\/AIDS and psychiatric disorders and their related risk factors among adults in Epworth, Zimbabwe","volume":"80","author":"Sebit MB","year":"2003","journal-title":"East Afr Med J"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.04.031"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-019-02443-6"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.1995.901013496.x"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000257"},{"issue":"11","key":"e_1_2_10_44_1","first-page":"797","article-title":"Developing the World Health Organization disability assessment schedule 2.0","volume":"88","author":"\u00dcst\u00fcn B","year":"2010","journal-title":"Bulletin of the World Health Organisation"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540120412331290194"},{"key":"e_1_2_10_46_1","unstructured":"Statistic Analytical System (SAS).Statistic Analytical System 9.4: SAS Analytics Software & Solutions;2014."},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1886-3"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607115593790"},{"issue":"1","key":"e_1_2_10_49_1","first-page":"30","article-title":"Alcohol use and problem drinking in South Africa: findings from a national population\u2010based survey","volume":"14","author":"Peltzer K","year":"2011","journal-title":"Afr J Psychiatry (Johannesbg)"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.2190\/DE.41.1.e"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.12127"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14218"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1080\/08039488.2019.1642382"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13132"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1769-7"},{"key":"e_1_2_10_56_1","volume-title":"AUDIT \u2010 the alcohol use disorders identification test: guidelines for use in primary health care","author":"Babor TF","year":"1989"},{"key":"e_1_2_10_57_1","article-title":"Alcohol consumption","author":"Ritchie H","year":"2018","journal-title":"Our World In Data"},{"key":"e_1_2_10_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2012.02.002"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.25641","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jia2.25641","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.25641","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T13:34:01Z","timestamp":1693661641000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.25641"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12]]},"references-count":57,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1002\/jia2.25641"],"URL":"https:\/\/doi.org\/10.1002\/jia2.25641","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12]]},"assertion":[{"value":"2020-04-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e25641"}}