Brief Motivational Intervention to Reduce Alcohol and HIV/Sexual Risk Behavior in Emergency Department Patients
the prevalence of co-occurring risky sexual behavior and drinking among
emergency department (ED) patients, we developed a motivational intervention
(MI) to address both behaviors. This study tested efficacy of a single-session
MI compared to brief advice (BA) for reducing heavy drinking and condomless sex
in adult ED patients screening positive for both.
randomized 372 patients to MI (n = 184) or BA (n = 188). Alcohol and sex risk
outcomes were assessed over 9 months.
estimating equations models analyzing 327 patients with follow-up data provided
strong support for efficacy of this integrated alcohol and sex-risk MI.
Compared to BA, and after controlling for baseline covariates, those in MI
reported significantly fewer heavy drinking days, drinks per week, and were
less likely to engage in excessive drinking over follow-up (all ps < .05).
MI was also favored over BA for reducing sex risk. Compared to BA, those in MI
reported significantly fewer days on which they engaged in condomless sex with
casual partners, had lower odds of reporting any condomless sex with a casual
partner, and reported fewer days of sex under the influence of alcohol/other
drugs (all ps < .05).
innovative MI was acceptable, feasible, and successfully delivered in 2
community hospitals and thus shows great promise for scalability and
dissemination into complex health settings where newly insured at-risk
individuals are likely to seek care.