Dataset Information

Effect of Rational Emotive Health Therapy on Alcohol Use Among Community-dwelling, HIV-positive Patients.

ABSTRACT:

Background

Patients who have tested positive for the human immunodeficiency virus (HIV) and who also experience alcohol use disorder (AUD) symptoms have worse clinical outcomes when compared with those who do not have AUD symptoms. The objective of the present study was to determine the effect of rational emotive health therapy (REHT) on AUD among community-dwelling, HIV-positive patients in the Southeastern region of Nigeria.

Methods

The research design included a pretest/post-test control group with a total of 124 community-dwelling, HIV-positive patients with AUD symptoms participating in the study. The measures employed for data collection included Alcohol-related Irrational Beliefs Scale (AIBS) and Alcohol Use Disorder Scale (AUDS). Repeated measures analysis of variance was used for statistical analysis.

Results

The result obtained at the initial assessment indicated that AUD was severe. Furthermore, REHT intervention led to a significant reduction in AUD symptoms, as shown by a reduction in AUDS and AIBS scores with time in the treatment group compared to those in the waitlist control group after the intervention. Also, the effect of REHT was positively maintained in the treatment group participants at follow-up assessment.

Conclusion

The presence of HIV symptoms alone does not cause HIV-positive patients to be dependent on alcohol; rather, irrational beliefs about the infection may contribute to unhealthy feelings and abuse of alcohol. Rational emotive health therapy is an effective approach that can be employed by therapists and health counselors in helping HIV-positive patients to think rationally about themselves and work to be able to overcome HIV-related, as well as alcohol-related, irrational beliefs.

SUBMITTER: Omeje JC

PROVIDER: S-EPMC6392950 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Publications

Effect of Rational Emotive Health Therapy on Alcohol Use Among Community-dwelling, HIV-positive Patients.

Omeje Joachim Chinweike JC Otu Mkpoikanke Sunday MS Aneke Anthonia Olunwa AO Adikwu Victoria Ogwa VO Nwaubani Okechukwu O OO Chigbu Eberechukwu Francisca EF Onuigbo Liziana N LN Udom Inwang Etim IE Aye Eucharia Nchedo EN Akaneme Immaculata Nwakaego IN Egeonu Doris Chika DC Ezema Victor Sunday VS Okpanachi Gabriel Ochaka GO Ohabuenyi Abah George AG Eseadi Chiedu C Eze Ngozi Mary NM

Medicine 20180801 35

<h4>Background</h4>Patients who have tested positive for the human immunodeficiency virus (HIV) and who also experience alcohol use disorder (AUD) symptoms have worse clinical outcomes when compared with those who do not have AUD symptoms. The objective of the present study was to determine the effect of rational emotive health therapy (REHT) on AUD among community-dwelling, HIV-positive patients in the Southeastern region of Nigeria.<h4>Methods</h4>The research design included a pretest/post-te ...[more]

PMID: 30170370

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Project description:ObjectiveThis study aimed to explore the effects of our rational emotive behavior therapy (REBT) program on symptoms, anxiety, depression, and sleep state in patients with colorectal cancer (CRC) undergoing chemotherapy.MethodsFrom October 2020 to May 2021, fifty-six patients with CRC in a hospital in the Hunan Province were randomly divided into an intervention group (n = 28) and a control group (n = 28). The patients in the intervention group completed a 6-week REBT program based on routine nursing care, including four courses: 1) establish a relationship and formulate health files; 2) group communications and study symptom management; 3) continuously provide health knowledge and strengthen healthy behavior; and 4) review the treatment and summary. The control group maintained routine nursing care. The simplified Chinese version of the Memorial Symptom Assessment Scale Short Form (MSAS-SF-SC), the Hospital Anxiety and Depression Scale (HADS), and the Pittsburgh Sleep Quality Index (PSQI) scale were used to investigate and compare the intervention effects of the two groups at baseline (T1, before the intervention), four weeks (T2), and six weeks (T3) after the intervention.ResultsThe intervention group was significantly improved in symptoms, anxiety, depression, and sleep state, compared with the control group. At T2, MSAS-SF-SC (24.43 ± 4.26 vs.28.07 ± 3.91), symptom distress (17.29 ± 4.04 vs. 19.39 ± 3.59), symptom frequency (7.14 ± 1.51 vs. 8.68 ± 1.42), HADS (13.68 ± 3.38 vs. 15.86 ± 3.79), anxiety (3.89 ± 1.85 vs. 5.18 ± 2.18), and depression (9.79 ± 2.06 vs. 10.68 ± 2.23), showed that the difference between the two groups was statistically significant (P < 0.05). At T3, MSAS-SF-SC (23.89 ± 3.54 vs. 30.14 ± 3.94), symptom distress (17.61 ± 3.52 vs. 21.32 ± 3.57), symptom frequency (6.29 ± 1.49 vs. 8.82 ± 1.47), HADS (11.82 ± 2.57 vs. 16.29 ± 3.13), anxiety (3.21 ± 1.64 vs. 5.61 ± 1.77), and depression (8.61 ± 1.52 vs. 10.68 ± 1.81), showed that the difference between the two groups was statistically significant (P < 0.05). The sleep state of the intervention group was better than the control group at T3, with decreased score of PSQI [4.00 (3.00,8.00) vs. 9.00 (7.00,12.50), Z = -3.706, P < 0.001].ConclusionThe 6-week REBT program can effectively improve the symptom, anxiety, depression, and sleep state of patients with CRC undergoing chemotherapy, which could as a care plan for patients with CRC who are repeatedly admitted to the hospital for chemotherapy.

Project description:BackgroundExcessive alcohol intake has been associated with poor adherence to antiretroviral therapy (ART). The impact of alcohol on viral suppression is particularly important among groups at high risk of HIV transmission, such as female sex workers (FSWs). Few studies have directly evaluated the association between alcohol use and HIV viral load. We hypothesized that hazardous or harmful alcohol use is associated with detectable plasma viral load among HIV-positive FSWs.MethodsA prospective cohort study was conducted among HIV-positive FSWs in Mombasa, Kenya. Hazardous or harmful alcohol use was assessed yearly and defined as an Alcohol Use Disorders Identification Test (AUDIT) score ≥7. Detectable viral load was assessed every six months and defined as ≥180 c/mL. Adherence measures were collected monthly and included late ART refill (>48 hours) and self-reported adherence, using both a validated self-rating scale of ability to take medication and visual analog scale (VAS) of ART use in the last month. Generalized estimating equations were used to estimate adjusted relative risks (aRR) and 95% confidence intervals (CI).ResultsThis analysis included 366 participants followed monthly between October 2012 and March 2018. At baseline, AUDIT scores indicated hazardous alcohol use (AUDIT 7-15) in 14.3%, harmful alcohol use (AUDIT 16-19) in 1.4%, and alcohol dependency (AUDIT ≥20) in 1.4% of participants. After adjusting for potential confounders, a combined exposure including hazardous, harmful, and dependent alcohol use was not associated with detectable viral load (aRR 1.10, 95%CI 0.63-1.92) or late ART refill (aRR 1.13, 95%CI 0.82-1.56), but was associated with lower self-rated ability to take medication (aRR 2.38, 95%CI 1.42-3.99) and a lower rate of self-reported perfect ART adherence by VAS (aRR 2.62, 95%CI 1.84-3.71).ConclusionsIn this FSW cohort, while participants reporting hazardous, harmful, or dependent alcohol use were not more likely to have a detectable viral load, they were more likely to report lower ART adherence. These results suggest that interventions targeting alcohol use among this population of FSWs may not have a large impact on viral suppression.

Project description:ImportanceZinc supplementation can reduce alcohol-related microbial translocation and inflammation.ObjectiveTo assess whether zinc supplementation reduces markers of mortality and risk of cardiovascular disease, reduces levels of inflammation and microbial translocation, and slows HIV disease progression in people with heavy alcohol use who are living with HIV/AIDS.Design, setting, and participantsThis study is a double-blinded placebo-controlled randomized clinical trial of zinc supplementation among participants recruited from 2013 to 2015. Participants were recruited from HIV and addiction clinical and nonclinical care sites in St Petersburg, Russia. Participants were adults (aged 18-70 years) with documented HIV infection who were antiretroviral therapy-naive at baseline and had past 30-day heavy alcohol consumption. Data analysis was performed from February 2017 to February 2020.InterventionPharmacy-grade zinc gluconate supplementation (15 mg for men and 12 mg for women, taken daily by mouth for 18 months) was compared with a placebo.Main outcomes and measuresThe primary outcome was mortality risk measured as a change in Veterans Aging Cohort Study (VACS) Index score between baseline and 18 months. The VACS Index scores range from 0 to 164, with higher scores indicating higher mortality risk. Secondary outcomes were change in CD4 cell count between baseline and 18 months, the assessment of cardiovascular disease risk (Reynolds Risk Score, which ranges from 0% to 100%, with higher scores indicating higher risk), and changes in inflammatory or microbial translocation biomarkers at 18 months. Adjusted linear regression analyses were performed.ResultsA total of 254 participants (184 men [72%]; mean [SD] age, 34 [6] years) were enrolled in the trial; 126 were randomized to receive zinc, and 128 were randomized to receive placebo. Participants had high CD4 cell counts (mean [SD], 521 [292] cells/mm3), and 188 (74%) reported heavy drinking in the past week. In the main analyses, zinc supplementation did not affect changes in the VACS Index score at 18 months (change for zinc, mean [SD], 0.49 [14.6]; median [interquartile range], 0.0 [-7.0 to 6.0]; change for placebo, mean [SD], 5.5 [17.2]; median [interquartile range], 6.0 [-6.0 to 14.0]; adjusted mean difference [AMD], -4.68; 95% CI, -9.62 to 0.25; P = .06) or any secondary outcomes, including change in CD4 cell count (AMD, 41.8 cells/mm3; 95% CI, -20.3 to 103.8 cells/mm3; P = .19), Reynolds Risk Score (AMD, -0.014; 95% CI, -0.167 to 0.139; P = .85), interleukin-6 level (AMD, -0.13 pg/mL; 95% CI, -0.38 to 0.11 pg/mL; P = .30), dimerized plasmin fragment D level (AMD, -0.21 μg/mL fibrinogen equivalent units; 95% CI, -0.48 to 0.07 μg/mL fibrinogen equivalent units; P = .14), soluble CD14 level (AMD, -38.01 ng/mL; 95% CI, -166.90 to 90.88 ng/mL; P = .56), intestinal fatty acid binding protein level (AMD, 0.08 pg/mL; 95% CI, -0.07 to 0.22 pg/mL; P = .32), and lipopolysaccharide binding protein level (AMD, -0.09 ng/mL; 95% CI, -0.23 to 0.06 ng/mL; P = .24). In the per-protocol analyses, zinc supplementation statistically significantly affected changes in the VACS Index score at 18 months (AMD, -7.49; 95% CI, -13.74 to -1.23; P = .02); however, the adherence rate to zinc supplementation was 51%.Conclusions and relevanceZinc supplementation did not reduce mortality risk, CD4 cell counts, cardiovascular disease risk, and levels of inflammation or microbial translocation in people with heavy alcohol use who are living with HIV/AIDS. Zinc supplementation did not change the VACS Index score but may have been limited by low adherence.Trial registrationClinicalTrials.gov Identifier: NCT01934803.

Project description:IntroductionUnhealthy alcohol use significantly contributes to viral non-suppression among persons with HIV (PWH). It is unknown whether brief behavioural interventions to reduce alcohol use can improve viral suppression among PWH with unhealthy alcohol use in sub-Saharan Africa (SSA).MethodsAs part of the SEARCH study (NCT04810650), we conducted an individually randomized trial in Kenya and Uganda of a brief, skills-based alcohol intervention among PWH with self-reported unhealthy alcohol use (Alcohol Use Disorders Identification Test-Consumption [AUDIT-C], prior 3 months, ≥3/female; ≥4/male) and at risk of viral non-suppression, defined as either recent HIV viral non-suppression (≥400 copies/ml), missed visits, out of care or new diagnosis. The intervention included baseline and 3-month in-person counselling sessions with interim booster phone calls every 3 weeks. The primary outcome was HIV viral suppression (<400 copies/ml) at 24 weeks, and the secondary outcome was unhealthy alcohol use, defined by AUDIT-C or phosphatidylethanol (PEth), an alcohol biomarker, ≥50 ng/ml at 24 weeks.ResultsBetween April and September 2021, 401 persons (198 intervention, 203 control) were enrolled from HIV clinics in Uganda (58%) and Kenya (27%) and alcohol-serving venues in Kenya (15%). At baseline, 60% were virally suppressed. Viral suppression did not differ between arms at 24 weeks: suppression was 83% in intervention and 82% in control arms (RR: 1.01, 95% CI: 0.93-1.1). Among PWH with baseline viral non-suppression, 24-week suppression was 73% in intervention and 64% in control arms (RR 1.15, 95% CI: 0.93-1.43). Unhealthy alcohol use declined from 98% at baseline to 73% in intervention and 84% in control arms at 24 weeks (RR: 0.86, 95% CI: 0.79-0.94). Effects on unhealthy alcohol use were stronger among women (RR 0.70, 95% CI: 0.56-0.88) than men (RR 0.93, 95% CI: 0.85-1.01) and among participants with a baseline PEth⩽200 ng/ml (RR 0.68, 95% CI: 0.53-0.87) versus >200 ng/ml (RR 0.97, 95% CI: 0.92-1.02).ConclusionsIn a randomized trial of 401 PWH with unhealthy alcohol use and risk for viral non-suppression, a brief alcohol intervention reduced unhealthy alcohol use but did not affect viral suppression at 24 weeks. Brief alcohol interventions have the potential to improve the health of PWH in SSA by reducing alcohol use, a significant driver of HIV-associated co-morbidities.

Project description:BACKGROUND:Although it has been purported that HIV-positive individuals may experience a greater degree of intoxication than HIV-negative individuals following acute alcohol consumption, no research to date has empirically tested this supposition. The present investigation entailed a randomized controlled experiment to identify whether the administration of a weight-specified dose of alcohol would lead to differential blood alcohol concentrations (BACs) among HIV-positive versus HIV-negative men. METHODS:In a specialized barroom laboratory, 143 men (n = 76 HIV-positive and n = 67 HIV-negative; mean age = 42.9) consumed beverages based on a formulation of 0.7 g alcohol/kg body weight over a 15-minute time frame. BAC was assessed via breathalyzer at 2 set time points (10 and 13 minutes postconsumption) and then periodically until detoxification (BAC < 0.040%). Primary outcomes included (i) area under the curve (AUC), calculated based on all of one's BAC readings, (ii) "BAC-EXP," defined as one's BAC reading 13 minutes postconsumption, and (iii) BAC-PEAK, defined as one's highest recorded BAC reading. RESULTS:Contrary to predictions, AUC (t(141) = 2.23, p = 0.027), BAC-EXP (t(141) = 2.68, p = 0.008), and BAC-PEAK (t(141) = 2.29, p = 0.023) were significantly lower among HIV-positive versus HIV-negative participants. These effects were sustained in multivariable models controlling for age, race, and AUDIT-based hazardous drinking classification. Among the HIV-positive sample, outcomes did not significantly differ based on HIV viral load detectability, antiretroviral therapy (ART) status, or ART adherence. CONCLUSIONS:The administration of a controlled, weight-specified dose of alcohol led to lower BACs among HIV-positive versus HIV-negative participants. These differences might derive from decreased body fat percentage and delayed gastric emptying associated with HIV seropositivity; however, additional research is necessary to verify these mechanisms. Unique alcohol dosing formulas based on HIV serostatus may be required in future alcohol administration experiments involving HIV-positive samples.

Dataset Information

Effect of Rational Emotive Health Therapy on Alcohol Use Among Community-dwelling, HIV-positive Patients.

Background

Methods

Results

Conclusion

Publications

Effect of Rational Emotive Health Therapy on Alcohol Use Among Community-dwelling, HIV-positive Patients.

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