Reducing non-injection drug use in HIV primary care: a randomized trial of brief motivational interviewing, with and without HealthCall, a technology-based enhancement
Open accessAbstract
Aims In HIV-infected individuals, non-injection drug use (NIDU) compromises many health outcomes. In HIV primary care, the efficacy of brief motivational interviewing (MI) to reduce NIDU is unknown, and drug users may need greater intervention. We designed an enhancement to MI, HealthCall (HC), for daily patient self-monitoring calls to an interactive voice response (IVR) phone system, and provided participants with periodic personalized feedback. To reduce NIDU among HIV primary care patients, we compared the efficacy of MI+HealthCall to MI-only and an educational control condition.Design Participants age >18 with >4days of NIDU during the prior 30days were recruited from large urban HIV primary care clinics. Of the 240 participants, 83 were randomly assigned to control, 77 to MI-only, and 80 to MI+HC. Counselors provided educational control, MI-only or MI+HC at baseline. At 30 and 60days (end-of-treatment), counselors briefly discussed drug use, moods and health behaviors, using HealthCall-generated graphs with MI+HC patients. Primary outcomes (last 30days) were number of days used primary drug (NumDU), and total quantity of primary drug used (dollar amount spent; QuantU), derived from the Time-Line Follow-Back.Findings Across all groups, at end-of-treatment, frequency and quantity of NIDU decreased, with significantly greater reductions in the MI-Only group. A twelve-month post-treatment follow-up indicated sustained benefits of MI+HC and MI-only relative to control.Conclusions Brief interventions can be successfully used to reduce non-injection drug use in HIV primary care. IVR-based technology may not be sufficiently engaging to be effective. Future studies should investigate mobile technology to deliver a more engaging version of HealthCall to diverse substance abusing populations.
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Self-citationAdams, A. S., Williams, T., Stein, D. J., Sibeko, G., SHOPTAW, S. J., & Rollnick, S. (2026) · South African Journal of Psychiatry · doi:10.4102/sajpsychiatry.v32i0.2555 · Cited by 3 · see citing works
- Authors
- Aharonovich, E., Sarvet, A., Stohl, M., DesJarlais, D., Tross, S., Hurst, T., Urbina, A., & Hasin, D.
- Affiliations
- Columbia University Irving Medical Center (US)
- New York State Psychiatric Institute (US)
- Icahn School of Medicine at Mount Sinai (US)
- Mount Sinai Health System (US)
- Corresponding author
- Aharonovich, Efrat
- Venue
- Journal of Substance Abuse Treatment
- Publisher
- Elsevier BV
- Published
- 2017-03
- Volume
- 74
- Pages
- 71-79
- ISSN
- 0740-5472 (ISSN-L)
- PMC
- PMC5931702
- OpenAlex
- W2567060720
- Cited by
- 30
- References
- 61
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 6 · 2022: 3 · 2021: 2 · 2020: 5 · 2019: 3 · 2018: 1 · 2017: 4
- FWCI
- 2.50
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Substance Abuse Treatment (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01AA014323, R01AA023163)
- National Institute on Drug Abuse (R01DA024606, T32DA031099, P30DA011041)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- non-injection drug use, HIV primary care, motivational interviewing, interactive voice response, patient self-monitoring, personalized feedback, brief intervention, substance use reduction, people living with HIV, mobile health technology
- MeSH terms
- Adult, Female, Follow-Up Studies, Humans, Male, Middle Aged, Primary Health Care, Telephone, HIV Infections, Outcome Assessment, Health Care, Substance-Related Disorders, Motivational Interviewing
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