Efficacy of the Common Elements Treatment Approach (CETA) for Unhealthy Alcohol Use Among Adults with HIV in Zambia: Results from a Pilot Randomized Controlled Trial

Kane, Jeremy C.; Sharma, Anjali; Murray, Laura K.; Chander, Geetanjali; Kanguya, Tukiya; Skavenski, Stephanie; Chitambi, Chipo; Lasater, Molly E.; Paul, Ravi; Cropsey, Karen; Inoue, Sachi; Bosomprah, Samuel; Danielson, Carla Kmett; Chipungu, Jenala; Simenda, Francis; Vinikoor, Michael J.

doi:10.1007/s10461-021-03408-4

Cited by 49Substance Abuse Treatment and OutcomesHIV, Drug Use, Sexual RiskPsychotherapy Techniques and Applications

Efficacy of the Common Elements Treatment Approach (CETA) for Unhealthy Alcohol Use Among Adults with HIV in Zambia: Results from a Pilot Randomized Controlled Trial

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Kane, Jeremy C., Sharma, Anjali, Murray, Laura K., Chander, Geetanjali, Kanguya, Tukiya, Skavenski, Stephanie, Chitambi, Chipo, Lasater, Molly E. +8 more·2022·AIDS and Behavior

DOI 10.1007/s10461-021-03408-4PMC PMC8322829

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Abstract

This randomized controlled trial tested the efficacy of a multi-session, evidence-based, lay counselor-delivered transdiagnostic therapy, the Common Elements Treatment Approach (CETA), in reducing unhealthy alcohol use and comorbidities among persons living with HIV (PLWH) in Zambia. Adult PLWH with (a) unhealthy alcohol use plus mental health or substance use comorbidities, or (b) severe unhealthy alcohol use were randomized to receive a single-session alcohol brief intervention (BI) alone or BI plus referral to CETA. Outcomes were measured at baseline and a 6-month follow-up and included Alcohol Use Disorders Identification Test (AUDIT) score (primary), depression and trauma symptoms, and other substance use (secondary). We enrolled 160 participants; 78 were randomized to BI alone and 82 to BI plus CETA. Due to COVID-19, the trial ended early before 36 participants completed. Statistically and clinically significant reductions in mean AUDIT score from baseline to 6-month follow-up were observed in both groups, however, participants assigned to BI plus CETA had significantly greater reductions compared to BI alone (− 3.2, 95% CI − 6.2 to − 0.1; Cohen’s d : 0.48). The CETA effect size for AUDIT score increased in line with increasing mental health/substance use comorbidity (0 comorbidities d = 0.25; 1–2 comorbidities d = 0.36; 3+ comorbidities d = 1.6). Significant CETA treatment effects were observed for depression, trauma, and several other substances. BI plus referral to CETA was feasible and superior to BI alone for unhealthy alcohol use among adults with HIV, particularly among those with comorbidities. Findings support future effectiveness testing of CETA for HIV outcomes among PLWH with unhealthy alcohol use. Clinical Trials Number: NCT03966885

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Single-session brief interventions resulted in reduced alcohol use at 6 months.
“Concerning alcohol use, single session BI resulted in reduced use at month 1 [50,54]; 6 weeks [72], 3 months [50,61–64], and 6 months [50,52,60,72].”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [60]
The Results (page unavailable) indicate that AUDIT scores fell by six months in the BI-alone group, but fell significantly more in the BI-plus-CETA group. Because the trial compared those two groups rather than BI alone with no intervention, it does not establish that the single-session BI itself caused the reduction. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Twelve included psychosocial treatment trials with 2106 participants reported on harmful alcohol use; all reported harmful alcohol use on a continuous scale.
“Twelve included psychosocial treatment trials with 2106 participants reported on harmful alcohol use. All of these trials reported harmful alcohol use on a continuous scale (Bolton 2014; Jordans 2019; Kane 2022; Madhombiro 2019; Madhombiro 2020; Moraes 2010; Murray 2020; Nadkarni 2017; Nadkarni 2019; Omeje 2018; Schaub 2021; Witte 2011).”
From Psychosocial and pharmacologic interventions to reduce harmful alcohol use in low- and middle-income countries (2023) · cites this paper as Kane 2022
Kane et al. additionally included some coping skills training in their BI.
“Kane et al. [60] additionally included some coping skills training in their BI.”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [60]
The Methods > Interventions section (page unavailable) says the BI was adapted from CETA’s Substance Use Reduction element, but does not describe coping-skills training as part of the BI; it directs readers to a separate protocol for the BI components. A search for coping skills in our copy found Cognitive Coping listed as a CETA element, not as a stated component of the BI. (LLM, conf=0.76)
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Common Elements Treatment Approach (CETA) for unhealthy alcohol use among persons with HIV in Zambia: Study protocol of the ZCAP randomized controlled trial
Kane, J. C., Sharma, A., Murray, L. K., Chander, G., Kanguya, T., Lasater, M. E., Skavenski, S. V. W., Paul, R., Mayeya, J., Danielson, C. K., et al. (2020) · Addictive Behaviors Reports · doi:10.1016/j.abrep.2020.100278 · Cited by 13 · see citing works
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Lasater, M. E., Kanguya, T., Chipungu, J., Kane, J. C., Skavenski, S. V. W., Murray, L. K., Vinikoor, M. J., & Sharma, A. (2023) · SSM - Mental Health · doi:10.1016/j.ssmmh.2023.100195 · Cited by 1 · see citing works
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Telemedicine for unhealthy alcohol use in adults living with HIV in Alabama using common elements treatment approach: A hybrid clinical efficacy-implementation trial protocol
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Provocative Findings From a Transdiagnostic Counseling Intervention to Improve Psychiatric Comorbidity and HIV Care Engagement Among People With HIV: A Pilot Randomized Clinical Trial
Pence, B. W., Darnell, D. A., Ranna-Stewart, M., Psaros, C., Gaynes, B. N., Grimes, L., Henderson, S., Parman, M. A., Filipowicz, T., Gaddis, K., et al. (2024) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000003457 · Cited by 1 · see citing works

Authors: Kane, J. C., Sharma, A., Murray, L. K., Chander, G., Kanguya, T., Skavenski, S., Chitambi, C., Lasater, M. E., Paul, R., Cropsey, K., Inoue, S., Bosomprah, S., Danielson, C. K., Chipungu, J., Simenda, F., & Vinikoor, M. J.
Affiliations: Johns Hopkins University (US)
Centre for Infectious Disease Research in Zambia (ZM)
University Teaching Hospital (ZM)
University of Alabama at Birmingham (US)
Columbia University (US)
Medical University of South Carolina (US)
Ministry of Health (ZM)
Corresponding author: Kane, Jeremy C.
ORCID: Kane, Jeremy C.
Sharma, Anjali
Murray, Laura K.
Chander, Geetanjali
Skavenski, Stephanie
Lasater, Molly E.
Paul, Ravi
Cropsey, Karen
Inoue, Sachi
Bosomprah, Samuel
Danielson, Carla Kmett
Chipungu, Jenala
Simenda, Francis
Vinikoor, Michael J.
Venue: AIDS and Behavior
Publisher: Springer Science and Business Media LLC
Published: 2021-07-30
Volume: 26
Issue: 2
Pages: 523-536
ISSN: 1090-7165 (ISSN-L)
1573-3254
DOI: 10.1007/s10461-021-03408-4
PMC: PMC8322829
OpenAlex: W3184840811
Semantic Scholar: 5306662734246bda704b2a3668e41a1ff3054aaa
Cited by: 49
References: 34
Citations by year: 2026: 5 · 2025: 6 · 2024: 9 · 2023: 12 · 2022: 15 · 2021: 2
FWCI: 6.84
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: AIDS and Behavior (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute on Alcohol Abuse and Alcoholism (R34AA027200, K01AA026523, K24AA027483)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords: Common Elements Treatment Approach, unhealthy alcohol use, HIV, brief alcohol intervention, transdiagnostic treatment, psychiatric comorbidity, substance use comorbidity, depression, trauma symptoms, auditing, Zambia
MeSH terms: COVID-19, SARS-CoV-2, Adult, Alcoholism, Humans, Pilot Projects, Zambia, HIV Infections

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Efficacy of the Common Elements Treatment Approach (CETA) for Unhealthy Alcohol Use Among Adults with HIV in Zambia: Results from a Pilot Randomized Controlled Trial

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