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Systematic Cultural Adaptation of Cognitive-Behavioral Therapy to Reduce Alcohol Use Among HIV-Infected Outpatients in Western Kenya |
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| Authors: | Rebecca K Papas 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 |
| Institution: | 1. Department of Medicine, Yale University School of Medicine, New Haven, CT, USA 3. Department of Medicine, Moi University School of Medicine, Eldoret, Kenya 2. Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA 4. Department of Behavioral Sciences, Moi University School of Medicine, Eldoret, Kenya 5. Department of Mental Health Services, Moi University School of Medicine, Eldoret, Kenya 6. Kenya Health Behavior Study, Eldoret, Kenya 7. National Institute of Alcohol Abuse and Alcoholism, Rockville, MD, USA 8. Department of Psychology, Syracuse University, Syracuse, NY, USA |
| 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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