International Mentored Scientist Award

In sub-Saharan Africa, screening and brief intervention (SBI) to reduce alcohol consumption may improve HIV treatment outcomes in HIV-infected hazardous drinkers. However, the feasibility, efficacy and effectiveness of this intervention in this region remains unknown. We propose to carry out a qualitative study to describe the feasibility of using SBI to reduce hazardous alcohol use in HIV infected adults in Uganda. Specific aims include: 1) assessing patients' and providers' attitudes towards SBI to reduce hazardous alcohol consumption amongst HIV-infected adults in Africa; and 2) assessing patients, providers', and community's attitudes towards alcohol consumption amongst HIV-infected adults in Africa, and current alcohol-related communication between health workers and HIV-infected patients in a sub-Saharan Africa setting. The study will be performed at the Immune Suppression Syndrome (ISS) clinic of Mbarara Regional Referral Hospital (MRRH) in Uganda. Patients will be recruited from an ongoing prospective cohort study currently being conducted by the UCSF Mentor (J. Hahn) examining the impact of alcohol consumption on pre-ART HIV disease progression. Data collection will include up to 10 video-recorded, in-depth, individual interviews with patients, and up to 10 video-recorded in-depth interviews with health providers and key informants Data will be analyzed iteratively using a phenomenological approach. Transcription, translation, and preliminary data analysis will be carried out iteratively so that emerging themes can be followed up in subsequent interviews. Preliminary data analysis will be followed by detailed thematic analysis which will be done manually using a block and file system. It is hoped that our results will inform our approach to reducing hazardous alcohol use in this population, and generate hypotheses for further study.