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Clinical Trial
. 2010 Jun;14(3):669-78.
doi: 10.1007/s10461-009-9647-6.

Systematic cultural adaptation of cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in western Kenya

Rebecca K Papas  1 , John E Sidle, Steve Martino, Joyce B Baliddawa, Rogers Songole, Otieno E Omolo, Benson N Gakinya, Michael M Mwaniki, Japheth O Adina, Tobista Nafula, Willis D Owino-Ong'or, Kendall J Bryant, Kathleen M Carroll, Joseph L Goulet, Amy C Justice, Stephen A Maisto
Affiliations
Clinical Trial

Systematic cultural adaptation of cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in western Kenya

Rebecca K Papas et al. AIDS Behav. 2010 Jun.

Abstract

Two-thirds of those with HIV worldwide live in sub-Saharan Africa. Alcohol use is associated with the HIV epidemic through risky sex and suboptimal ARV adherence. In western Kenya, hazardous drinking was reported by HIV (53%) and general medicine (68%) outpatients. Cognitive behavioral treatment (CBT) has demonstrated strong efficacy to reduce alcohol use. This article reports on a systematic cultural adaptation and pilot feasibility study of group paraprofessional-delivered CBT to reduce alcohol use among HIV-infected outpatients in Eldoret, Kenya. Following adaptation and counselor training, five pilot groups were run (n = 27). Overall attendance was 77%. Percent days abstinent from alcohol (PDA) before session 1 was 52-100% (women) and 21-36% (men), and by session 6 was 96-100% (women) and 89-100% (men). PDA effect sizes (Cohen's d) between first and last CBT session were 2.32 (women) and 2.64 (men). Participants reported treatment satisfaction. Results indicate feasibility, acceptability and preliminary efficacy for CBT in Kenya.

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Figures

Figure 1
Figure 1
Rural illustration of conditioned cravings Acknowledgment: created by Robert Skipworth Comer, Indiana University School of Informatics
Figure 2
Figure 2
Mean reported abstinence from alcohol prior to each CBT session for five pilot groups
See this image and copyright information in PMC

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