HIV Insight: CBT

Showing posts with label CBT. Show all posts

Monday, October 19, 2015

Targeting an Alcohol Intervention Cost-Effectively to Persons Living with HIV/AIDS in East Africa

In the current report, we ask if targeting a cognitive behavioral therapy (CBT)-based intervention aimed at reducing hazardous alcohol consumption to HIV-infected persons in East Africa would have a favorable value at costs that are feasible for scale-up.

Using a computer simulation to inform HIV prevention decisions in East Africa, we compared 4 different strategies for targeting a CBT intervention-(i) all HIV-infected persons attending clinic; (ii) only those patients in the pre-antiretroviral therapy (ART) stages of care; (iii) only those patients receiving ART; and (iv) only those patients with detectable viral loads (VLs) regardless of disease stage. We define targeting as screening for hazardous alcohol consumption (e.g., using the Alcohol Use Disorders Identification Test and offering the CBT intervention to those who screen positive). We compared these targeting strategies to a null strategy (no intervention) or a hypothetical scenario where an alcohol intervention was delivered to all adults regardless of HIV status.

An intervention targeted to HIV-infected patients could prevent 18,000 new infections, add 46,000 quality-adjusted life years (QALYs), and yield an incremental cost-effectiveness ratio of $600/QALY compared to the null scenario. Narrowing the prioritized population to only HIV-infected patients in pre-ART phases of care results in 15,000 infections averted, the addition of 21,000 QALYs and would be cost-saving, while prioritizing based on an unsuppressed HIV-1 VL test results in 8,300 new infections averted, adds 6,000 additional QALYs, and would be cost-saving as well.

Our results suggest that targeting a cognitive-based treatment aimed at reducing hazardous alcohol consumption to subgroups of HIV-infected patients provides favorable value in comparison with other beneficial strategies for HIV prevention and control in this region. It may even be cost-saving under certain circumstances.

Full article at: http://goo.gl/k7hpwt

By: Kessler J1, Ruggles K1, Patel A1,2, Nucifora K1, Li L1, Roberts MS3, Bryant K4, Braithwaite RS1.

1Department of Population Health, NYU School of Medicine, New York, New York.
2Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
3Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
4National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland.

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Tuesday, October 13, 2015

A Group Intervention to Reduce Intimate Partner Violence among Female Drug Users. Results from a Randomized Controlled Pilot Trial in a Community Substance-Abuse Center

A greater proportion of drug dependent women are victims of intimate partner violence (IPV) than women in the general population; however, few interventions have been developed to reduce IPV among drug dependent women.

An adapted version of the Women's Wellness Treatment, to address IPV and depressive symptoms, was piloted in a randomized controlled trial conducted in outpatient treatment program in Barcelona, Spain among 14 women receiving outpatient treatment for a drug use disorder who screened positive for IPV in the previous month. Participants were randomly assigned to receive the 10 session cognitive behavioral therapy (IPaViT-CBT) group intervention or treatment as usual. The frequency of IPV, depressive symptoms, substance use, quality of life and health status were assessed at baseline and 1, 3 and 12 months post intervention. Intention to treat analysis was performed.

Moderate effects for the intervention were found in reducing psychological maltreatment, increasing assertiveness of IPV and reducing aggressiveness in the partner relationship, and in reducing the frequency of drinking up to 3 months post intervention. The intervention did not significantly reduce the likelihood of any IPV, depressive symptoms, quality of life or self-reported health status, up to 12-months post intervention.

This pilot trial suggests some initial support for the 10-session CBT group intervention among IPV victims who received treatment for drug use. Study findings indicate that it is feasible to deliver the intervention in a community substance abuse center. An adequately powered trial is required to replicate these results.

Purchase full article at: http://goo.gl/mZQ9hB

By: Tirado-Muñoz J1, Gilchrist G, Lligoña E, Gilbert L, Torrens M.

1Addiction Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques; Universitat Autónoma de Barcelona, Barcelona.

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Friday, September 18, 2015

mHealth App for Marijuana Users: Satisfaction and Perceived Usefulness

The aim of this study was to describe the characteristics of cannabis users and their levels of satisfaction with Stop-cannabis, an app intended for cannabis users who want to stop or reduce their cannabis use or prevent relapse.

A cross-sectional online survey was administered to users of Stop-cannabis, a French-language app for iOS and Android devices. All app users were invited to participate in the survey via a message sent to the app.

For hundred and eighty-two users answered the survey. The app was used daily by 348 of the participants (around 70%). More than 80% of participants (397) considered the app to have helped them “a little” or “a lot” to stop or reduce cannabis consumption. Most of the users’ suggestions were related to the number or the quality of the messages sent by, or displayed in, the app.

This pilot study supports the feasibility of such an app and its perceived usefulness. A self-selection bias, however, limits the conclusions of the study. The efficacy of the app should be evaluated in a randomized controlled trial.

Below: Screenshots of the welcome page, the Feedback page, and the main screen with the benefits of change