Common Elements Treatment Approach (CETA) for unhealthy alcohol use among persons with HIV in Zambia: Study protocol of the ZCAP randomized controlled trial. (December 2020)

• Record Type: Journal Article
• Authors: Kane, Jeremy C.; Sharma, Anjali; Murray, Laura K.; Chander, Geetanjali; Kanguya, Tukiya; Lasater, Molly E.; Skavenski, Stephanie; Paul, Ravi; Mayeya, John; Kmett Danielson, Carla; Chipungu, Jenala; Chitambi, Chipo; Vinikoor, Michael J.
• Is Part Of: Addictive behaviors reports. Volume 12(2020)
• Publication Date: 2020-12
• Subjects: Unhealthy alcohol use -- Substance use -- HIV -- Zambia -- Randomized controlled trial -- Transdiagnostic therapy -- Brief intervention; Compulsive behavior -- Periodicals; 616.8584
• DOI: 10.1016/j.abrep.2020.100278
• Languages: English
• ISSNs: 2352-8532

Abstract

Highlights: Unhealthy alcohol use is common among persons living with HIV (PLWH). In sub-Saharan Africa, there are limited treatment options for unhealthy alcohol use. This RCT tests multiple interventions at reducing unhealthy alcohol use in SSA. Abstract: Aims: Prevalence of unhealthy alcohol use and co-occurring mental health problems is high among persons living with HIV (PLWH) in sub-Saharan Africa (SSA). Yet, there is a dearth of evidence-based treatment options that can address both unhealthy alcohol use and comorbidities in SSA HIV care settings. Recent studies testing single-session alcohol brief interventions (BIs) among PLWH in SSA have suggested that more robust treatments are needed. This paper describes the protocol of a pilot randomized controlled superiority trial that will test the effectiveness of an evidence-based transdiagnostic multi-session psychotherapy, the Common Elements Treatment Approach (CETA), compared to a control condition consisting of a single session brief alcohol intervention (BI) based on CETA, at reducing unhealthy alcohol use, mental health problems, and other substance use among PLWH in urban Zambia. Methods: The study is a single-blind, parallel, individually randomized trial conducted in HIV treatment centers in Lusaka. 160 PLWH who meet criteria for unhealthy alcohol use + mental health or substance use comorbidities and/or have a more severe alcohol use disorder are eligible. Participants are randomized 1:1 to receive the single-session BI or CETA. Outcomes are assessed at baseline and a six-month follow-up and include unhealthy alcohol use, depression, trauma symptoms, and other substance use. Conclusions: The trial is a first step in establishing the effectiveness of CETA at reducing unhealthy alcohol use and comorbidities among PLWH in SSA. If effectiveness is demonstrated, a larger trial featuring long-term follow-ups and HIV treatment outcomes will be undertaken.