Comparing Brief Alcohol Interventions For HIV-HCV Co-infected Persons

Two types of brief intervention, Brief Advice (BA) and Motivational Interviewing (MI), have been shown to be efficacious in reducing drinking in non-HIV samples. Our goal is to determine whether offering counseling beyond Brief Advice, namely MI, has greater alcohol reduction effects. In the proposed randomized trial, all 300 HIV-HCV co-infected participants will receive BA delivered by their HIV PCP during a regular HIV visit and will then be randomized to either a 30-minute Motivational Interviewing Intervention with a Behavioral Counselor (MI) or to HIV clinic treatment-as-usual. After this initial meeting, drinking "check-in" (MI or BA) sessions will then be provided telephonically every three months for 18 months. Research assessments will also be done every three months, with a final assessment at 24 months. Our primary outcome is drinks per week.

Inclusion criteria

• HIV+
• HCV RNA positive
• consuming on average at least 4 alcoholic drinks per week in the last month
• 18 years or older

Exclusion criteria

• current, severe psychiatric symptoms requiring immediate clinical attention (e.g., suicidal ideation, current mania, psychosis)
• inability to understand English
• cognitive impairment severe enough to interfere with ability to actively participate
• hepatocellular carcinoma or life expectancy less than 24 months
• plan to move from Providence area in the next 24 months