HIV/AIDS Risk Reduction Counseling for Alcohol Using Sexually Transmitted Infections Clinic Patients in Cape Town, South Africa
Abstract
BACKGROUND: HIV is ravaging southern Africa, and HIV transmission risk behaviors are facilitated by alcohol use in sexual contexts. There are no known interventions that directly target HIV risk behavior among people who drink and are at risk for HIV in Africa. PURPOSE: To test a behavioral risk reduction counseling intervention for use in sexually transmitted infection (STI) clinics in southern Africa. METHODS: A randomized intervention trial was conducted with 143 STI clinic patients in Cape Town, South Africa. Participants received an experimental 60-minute HIV and alcohol risk reduction behavioral skills intervention or a control 20-minute HIV education condition. Participants were followed for 3 and 6 months after the intervention, with 73% retention. RESULTS: Overall, the experimental intervention demonstrated more than a 25% increase in condom use and a 65% reduction in unprotected intercourse over the 6-month follow-up period, with risk reduction significantly greater for the experimental condition than for the control condition at both follow-ups. Alcohol use in sexual contexts [F(1,94) = 6.2; P < 0.05] and expectancies that alcohol enhances sexual experiences [F(1,94) = 8.3; P < 0.01] were also significantly lower for the experimental condition at the 3-month follow-up. CONCLUSIONS: An HIV prevention counseling intervention reduced HIV transmission risks for up to 6 months in this STI clinic population. Effects may be sustained with structural interventions to reduce alcohol use in sexual contexts and support risk reduction behavior changes over the long-term.
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One randomized study (not limited to young adults) of patients in Cape Town South Africa clinics for sexually transmitted infections found that a behavioral skills intervention was effective in reducing alcohol use in sexual contexts.
“One randomized study (not limited to young adults) of patients in Cape Town South Africa clinics for sexually transmitted infections found that a behavioral skills intervention was effective in reducing alcohol use in sexual contexts (Kalichman et al., 2007).”
From Effectiveness of Nurse-Practitioner-Delivered Brief Motivational Intervention for Young Adult Alcohol and Drug Use in Primary Care in South Africa: A Randomized Clinical Trial (2014) · cites this paper as Kalichman et al., 2007
Interventions for AUD have been reported in various general health care settings in sub-Saharan Africa, including HIV or sexually transmitted disease services, antenatal and postnatal care, tuberculosis care, and inpatient and outpatient care.
“In SSA, interventions for AUD have been reported in various general health care settings (3, 17–27), including services for people with HIV or other sexually transmitted diseases (9, 10, 13–16, 18, 21), antenatal and postnatal care (19, 27–29), care for people with tuberculosis (30, 31), inpatient and outpatient care (20, 26, 32–35).”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [25]
The majority of health promotion and education programs addressed alcohol use in the context of HIV/AIDS prevention and risk reduction.
“The majority of programs addressed alcohol use in the context of HIV/AIDS prevention and risk reduction [38–40,43,56,57,95].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [57]
About half (8 of 17) of the health promotion and education interventions were found to have positive results.
“About half (8 of 17) of the health promotion and education interventions were found to have positive results [25,26,38,39,54,56,57,65,66,84].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [57]
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- Authors
- Kalichman, S. C., Simbayi, L. C., Vermaak, R., Cain, D., Jooste, S., & Peltzer, K.
- Affiliations
- University of Connecticut (US)
- Corresponding author
- Kalichman, Seth C
- Cain, Demetria
- Venue
- JAIDS Journal of Acquired Immune Deficiency Syndromes
- Published
- 2007-04-15
- Volume
- 44
- Issue
- 5
- Pages
- 594-600
- ISSN
- 1525-4135 (ISSN-L)
- OpenAlex
- W2063499006
- Cited by
- 114
- References
- 2
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 2 · 2018: 5 · 2017: 10 · 2016: 4 · 2015: 11 · 2014: 13 · 2013: 8 · 2012: 9
- FWCI
- 7.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAIDS Journal of Acquired Immune Deficiency Syndromes (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R21AA014820)
- Topics
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- HIV prevention, risk reduction counseling, sexually transmitted disease clinics, condom use, unprotected sex, alcohol expectancies, HIV risk behavior, Cape Town
- MeSH terms
- Adult, Alcohol Drinking, Counseling, Female, Humans, Male, South Africa, HIV Infections, Outcome Assessment, Health Care, Condoms, Risk Reduction Behavior, Unsafe Sex
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