Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2017 Mar:74:71-79.
doi: 10.1016/j.jsat.2016.12.009. Epub 2016 Dec 30.

Reducing non-injection drug use in HIV primary care: A randomized trial of brief motivational interviewing, with and without HealthCall, a technology-based enhancement

Efrat Aharonovich  1 , Aaron Sarvet  2 , Malki Stohl  2 , Don DesJarlais  3 , Susan Tross  4 , Teresa Hurst  5 , Antonio Urbina  5 , Deborah Hasin  6
Affiliations
Randomized Controlled Trial

Reducing non-injection drug use in HIV primary care: A randomized trial of brief motivational interviewing, with and without HealthCall, a technology-based enhancement

Efrat Aharonovich et al. J Subst Abuse Treat. 2017 Mar.

Abstract

Aims: In HIV-infected individuals, non-injection drug use (NIDU) compromises many health outcomes. In HIV primary care, the efficacy of brief motivational interviewing (MI) to reduce NIDU is unknown, and drug users may need greater intervention. We designed an enhancement to MI, HealthCall (HC), for daily patient self-monitoring calls to an interactive voice response (IVR) phone system, and provided participants with periodic personalized feedback. To reduce NIDU among HIV primary care patients, we compared the efficacy of MI+HealthCall to MI-only and an educational control condition.

Design: Participants age >18 with >4days of NIDU during the prior 30days were recruited from large urban HIV primary care clinics. Of the 240 participants, 83 were randomly assigned to control, 77 to MI-only, and 80 to MI+HC. Counselors provided educational control, MI-only or MI+HC at baseline. At 30 and 60days (end-of-treatment), counselors briefly discussed drug use, moods and health behaviors, using HealthCall-generated graphs with MI+HC patients. Primary outcomes (last 30days) were number of days used primary drug (NumDU), and total quantity of primary drug used (dollar amount spent; QuantU), derived from the Time-Line Follow-Back.

Findings: Across all groups, at end-of-treatment, frequency and quantity of NIDU decreased, with significantly greater reductions in the MI-Only group. A twelve-month post-treatment follow-up indicated sustained benefits of MI+HC and MI-only relative to control.

Conclusions: Brief interventions can be successfully used to reduce non-injection drug use in HIV primary care. IVR-based technology may not be sufficiently engaging to be effective. Future studies should investigate mobile technology to deliver a more engaging version of HealthCall to diverse substance abusing populations.

Keywords: Drug use; HIV; IVR intervention; Motivational interviewing.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest

None.

Figures

Fig. 1
Fig. 1
CONSORT diagram of participants flow and data availability1 in a study of HealthCall based IVR to reduce non-injection drug use. 1Participants who missed assessment provided data for that period by completing a retrospective TLFB at their subsequent assessment.
Fig. 2
Fig. 2
Sample personalized HealthCall data based graph showing goal set at $3; $0 = no use. Graphs were part of the feedback given in the MI+HealthCall arm at 30 and 60-day visits.
Fig. 3
Fig. 3
Means of number of drug used days by treatment group.
Fig. 4
Fig. 4
Means of quantity use (dollar amount) by treatment group.
See this image and copyright information in PMC

References

    1. Aberg JA, Gallant JE, Anderson J, Oleske JM, Libman H, Currier JS, et al. Primary care guidelines for the management of persons infected with human immunodeficiency virus: Recommendations of the HIV Medicine Association of the Infectious Diseases Society of America. Clinical Infectious Diseases. 2004;39(5):609–629. - PubMed
    1. Aharonovich E, Greenstein E, O’Leary A, Johnston B, Seol SG, Hasin DS. HealthCall: Technology-based extension of motivational interviewing to reduce non-injection drug use in HIV primary care patients - a pilot study. AIDS Care. 2012;24(12):1461–1469. - PMC - PubMed
    1. Aharonovich E, Stohl M, Cannizzaro D, Hasin D. Mobile HealthCall to reduce concurrent non-injection drug and alcohol use in a randomized pilot trial. 2016 Under review. - PMC - PubMed
    1. Baum MK, Rafie C, Lai S, Sales S, Page JB, Campa A. Crack-cocaine use accelerates HIV disease progression in a cohort of HIV-positive drug users. Journal of Acquired Immune Deficiency Syndromes. 2009;50(1):93–99. - PubMed
    1. Carrico AW, Johnson MO, Moskowitz JT, Neilands TB, Morin SF, Charlebois ED, et al. Affect regulation, stimulant use, and viral load among HIV-positive persons on anti-retroviral therapy. Psychosomatic Medicine. 2007;69(8):785–792. - PubMed

Publication types