Alcohol and ART Adherence in India

NCT ID: NCT03746457

Last Updated: 2018-12-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

940 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-05-10

Study Completion Date

2018-10-15

Brief Summary

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The focus of this project was to reduce alcohol consumption among male "persons living with HIV" (PLHIV) on antiretroviral treatment (ART) at government hospitals in urban Maharashtra, India and factors associated with both these outcomes including depression, stigma, social support networks, quality of life and health status. The project consisted of three phases; formative research, implementation of multilevel interventions and analysis of process and outcome data. The project utilized a crossover design to compare outcomes of individual interventions and the sequences of intervention.

Detailed Description

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The focus of this project was to reduce alcohol consumption among male "persons living with HIV" (PLHIV) on antiretroviral treatment (ART) at government hospitals in urban Maharashtra, India and factors associated with both these outcomes including depression, stigma, social support networks, quality of life and health status.

The project consisted of three phases; formative research, intervention implementation and analysis and dissemination. Formative research included key informant interviews and observation at the ART Centers, screening of close to 10,000 patients to identify male PLHIV who met the eligibility criteria, a baseline survey instrument (T1) that assessed a wide range of variables associated with the outcome variables and modeling alternative intervention programs for impact and cost effectiveness. Of 13 ART Centers in the Mumbai, Navi Mumbai, and Thane areas of Maharashtra, five ART Centers were selected for the project with a sample of 940 male PLHIV, 188 from each of the five ART Centers.

The second phase of the project was the development and implementation of three interventions assigned randomly to each of the experimental ART Centers with two of the Centers selected randomly as controls. The interventions were individual counseling (IC), group intervention (GI) and collective advocacy (CA). In Cycle 1 of the intervention phase, the interventions were implemented in each of three experimental ART Centers. In Cycle 2, each of the experimental centers received a second intervention (e.g. GI in Cycle 1+ IC in Cycle 2) and in Cycle 3 each of the experimental Centers received the third intervention (GI in Cycle 1 + IC in Cycle 2 + CA in Cycle 3). In addition, in Cycle 3, one of the two controls received an integrated package of IC, GI and CA. This crossover design test the sequencing and packaging of multi-level interventions for behavior change by examining the efficacy of any one intervention versus control, any two combinations of interventions versus controle, all interventions versus control and the integrated package versus control.

The IC intervention involved one-on-one interaction with a project counselor involving a pre-intervention session in which the PLHIV participant selected the priority issues to be discussed and four additional sessions to address tensions and anxieties, stigma and disclosure, relationships and alcohol and adherence. The sessions were facilitated by in the use of a tablet both to structure the interaction and to collect process data. GI involved four sessions in which 6-10 PLHIV were gathered for intervention on healthy living with HIV, tension, relationships and alcohol and adherence. CA involved groups of 10-15 PLHIV in five sessions in which the focus was on increasing the capacity of participants to advocate both for themselves and a collective group for issues that affected PLHIV human rights, entitlements and services.

The third and current phase of the project is analysis of qualitative data including key informant and in-depth interviews with PLHIV and assessments of fidelity and acceptability of the interventions and quantitative data that includes the screening instrument and baseline (T1) and follow-up outcome data (T2, T3, T4 follow-up surveys after each intervention for both experimental and control centers. This phase will also involve dissemination of results to the National AIDS Control Organizations and its subsidiaries at the State and District levels, the participating ART Centers and to Positive Peoples' Networks at the state and national levels and to national and international meetings and publications.

Conditions

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Alcohol Consumption HIV Infection Primary

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

CROSSOVER

Participants in the three experimental ART Centers received three cycles of intervention, while two ART Centers served as the controls. In the first cycle, participants in the three experimental Centers each received individual counseling, group intervention (GI) and collective advocacy (CA). In Cycle 2, participants in each experimental center received a second intervention (e.g. GI + CA) and in the third cycle, participants in each experimental Center received a third intervention (GI + CA + IC). In addition, in Cycle 3, the participants in one of the Control Centers received an integrated package of IC-GI-CI.
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Control ART Center

Control arm with no intervention throughout the course of the study

Group Type NO_INTERVENTION

No interventions assigned to this group

Control and Cycle 3 integrated package

Control arm in Cycles 1 and 2 and in Cycle three converts to experimental

Group Type ACTIVE_COMPARATOR

Behavioral intervention

Intervention Type BEHAVIORAL

Individual counseling, group intervention, collective advocacy

GI + CA + IC

Receives one alternative sequence of three interventions

Group Type EXPERIMENTAL

Behavioral intervention

Intervention Type BEHAVIORAL

Individual counseling, group intervention, collective advocacy

IC + GI + CA

Receives a second alternative sequence of three interventions

Group Type EXPERIMENTAL

Behavioral intervention

Intervention Type BEHAVIORAL

Individual counseling, group intervention, collective advocacy

CA + IC + GI

Receives a third alternative sequence of three interventions

Group Type EXPERIMENTAL

Behavioral intervention

Intervention Type BEHAVIORAL

Individual counseling, group intervention, collective advocacy

Interventions

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Behavioral intervention

Individual counseling, group intervention, collective advocacy

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Male
* age 18-60
* six months or more on ART
* consumed alcohol at least once in the last 30 days

Exclusion Criteria

* Female
* outside the age range
* less than 6 months on ART
* did not consume alcohol in the last 30 days
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Institute for Community Research

UNKNOWN

Sponsor Role collaborator

International Center for Research on Women

UNKNOWN

Sponsor Role collaborator

Population Council

OTHER

Sponsor Role collaborator

UConn Health

OTHER

Sponsor Role lead

Responsible Party

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Stephen Schensul

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Stephen L Schensul, PhD

Role: PRINCIPAL_INVESTIGATOR

UConn Health

Jean J Schensul, PhD

Role: PRINCIPAL_INVESTIGATOR

Institute for Community Research

Niranjan Saggurti, PhD

Role: PRINCIPAL_INVESTIGATOR

Population Council, India Country office

Avina Sarna, MD

Role: PRINCIPAL_INVESTIGATOR

Population Council, India Country office

Locations

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University of Connecticut Health

Farmington, Connecticut, United States

Site Status

Countries

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United States

References

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Schensul SL, Ha T, Schensul JJ, Vaz M, Singh R, Burleson JA, Bryant K. The Role of Alcohol on Antiretroviral Therapy Adherence Among Persons Living With HIV in Urban India. J Stud Alcohol Drugs. 2017 Sep;78(5):716-724. doi: 10.15288/jsad.2017.78.716.

Reference Type RESULT
PMID: 28930059 (View on PubMed)

Schensul JJ, Ha T, Schensul S, Sarna A, Bryant K. Identifying the Intersection of Alcohol, Adherence and Sex in HIV Positive Men on ART Treatment in India Using an Adapted Timeline Followback Procedure. AIDS Behav. 2017 Nov;21(Suppl 2):228-242. doi: 10.1007/s10461-017-1916-1.

Reference Type RESULT
PMID: 28993911 (View on PubMed)

Ruggles KV, Patel AR, Schensul S, Schensul J, Nucifora K, Zhou Q, Bryant K, Braithwaite RS. Betting on the fastest horse: Using computer simulation to design a combination HIV intervention for future projects in Maharashtra, India. PLoS One. 2017 Sep 5;12(9):e0184179. doi: 10.1371/journal.pone.0184179. eCollection 2017.

Reference Type RESULT
PMID: 28873452 (View on PubMed)

Patel AR, Ruggles KV, Nucifora K, Zhou Q, Schensul S, Schensul J, Bryant K, Braithwaite RS. Evaluating Alternative Designs of a Multilevel HIV Intervention in Maharashtra, India: The Impact of Stakeholder Constraints. MDM Policy Pract. 2018 Oct 16;3(2):2381468318803940. doi: 10.1177/2381468318803940. eCollection 2018 Jul-Dec.

Reference Type RESULT
PMID: 30349875 (View on PubMed)

Ha T, Pham TQ, Misra S, Su TW, Ha L, Cunningham SD, Carandang RR, Schensul SL. Impact of multilevel interventions on reducing reasons for drinking among men living with HIV. AIDS Care. 2025 Oct;37(10):1696-1705. doi: 10.1080/09540121.2025.2547030. Epub 2025 Aug 22.

Reference Type DERIVED
PMID: 40844326 (View on PubMed)

Ha T, Shi H, Pham BN, Dsouza A, Shrestha R, Kuchipudi SV, Luu HN, Le NT, Schensul SL. Assessing the Effectiveness of Multilevel Intervention Sequences on "Tension" Among Men Living with HIV: A Randomized-Control Trial. Int J Behav Med. 2024 Jul 29. doi: 10.1007/s12529-024-10310-5. Online ahead of print.

Reference Type DERIVED
PMID: 39073518 (View on PubMed)

Ha T, Shi H, Shrestha R, Gaikwad SS, Joshi K, Padiyar R, Schensul SL. The Mediating Effect of Changes in Depression Symptoms on the Relationship between Health-Related Quality of Life and Alcohol Consumption: Findings from a Longitudinal Study among Men Living with HIV in India. Int J Environ Res Public Health. 2023 Apr 18;20(8):5567. doi: 10.3390/ijerph20085567.

Reference Type DERIVED
PMID: 37107849 (View on PubMed)

Schensul SL, Ha T, Schensul JJ, Grady J, Burleson JA, Gaikwad S, Joshi K, Malye R, Sarna A. Multilevel and Multifactorial Interventions to Reduce Alcohol Consumption and Improve ART Adherence and Related Factors Among HIV Positive Men in Mumbai, India. AIDS Behav. 2021 Dec;25(Suppl 3):290-301. doi: 10.1007/s10461-021-03303-y. Epub 2021 May 20.

Reference Type DERIVED
PMID: 34014429 (View on PubMed)

Other Identifiers

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U01AA021990

Identifier Type: NIH

Identifier Source: org_study_id

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