Reducing Heavy Drinking and Improving HIV Prevention and Treatment Among Adults Receiving STI Care in Lilongwe, Malawi

What this Trial Is About

Researchers are evaluating the short-term effectiveness and implementation of Treat4All, an alcohol reduction intervention designed to decrease heavy drinking and improve HIV-related outcomes. The study focuses on two groups people with HIV who have a history of unsuppressed viral load or poor ART adherence and individuals at high risk for HIV who report recent heavy drinking and no recent PrEP use. About 160 participants aged 18 or older will be enrolled in this pilot randomized controlled trial comparing Treat4All to usual care. Participants in the Treat4All group will receive three weekly individual in-person sessions over three weeks, tailored to their specific issues and HIV status. These sessions include personalized feedback on alcohol use, education on alcohols impact on STI risk, goal setting, and strategies to improve HIV prevention and treatment engagement, such as ART adherence and PrEP use. The usual care group will receive sexual risk reduction counseling that includes advice on reducing alcohol use before sex and abstaining from alcohol while on ART. All participants will receive counseling and referral to HIV care as needed. Participants will complete baseline, 3-month, and 6-month assessments including face-to-face questionnaires on alcohol use, HIV testing, health status, quality of life, and other relevant measures. Laboratory tests for HIV viral load, STI screening, and alcohol biomarkers will be conducted at baseline and 6 months. HIV-negative participants will be retested for HIV at 6 months. The study includes randomization to intervention or usual care and ongoing monitoring to assess heavy drinking days and engagement in HIV prevention or treatment six months after enrollment.

Enhancing HIV Prevention and Reducing Alcohol Use Among People Receiving STI Care in Lilongwe, Malawi