# 3/3 Alcohol Research Consortium in HIV - Intervention Research Arm (ARCH-IRA)

> **NIH NIH U01** · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2020 · $347,377

## Abstract

Alcohol Use Disorders (AUDs) and hazardous drinking are the fourth leading cause of preventable death in the
US and are responsible for 10% of all deaths among working age adults. Among Persons Living with HIV/AIDS
(PLWH), heavy alcohol use is up to twice the rate in the general population. Few people engage in behavioral
alcohol treatment and alcohol pharmacotherapies are not routinely used as part of alcohol treatment, despite
the known efficacy of these interventions. PLWH engaged in treatment for their HIV disease have regular
contact with a medical provider and are treated in a medical home model in which all medical services are
delivered within HIV clinics, but few HIV providers feel comfortable treating AUDs. During our initial funding
period, we implemented routine alcohol screening, developed a computerized brief intervention (CBI), and
conducted provider training on alcohol pharmacotherapies. However, while we found a strong impact from
routine screening with CBI for reducing alcohol use, few providers prescribed alcohol pharmacotherapy,
despite this specialized training, with most indicating continued discomfort and lack of knowledge for use of
pharmacotherapy. Algorithms are used routinely to guide providers in treatment selection for many different
disorders that are not within their specialty such as diabetes management, obesity, arthritis, and other
disorders. In addition, we tested the use of provider algorithms for the treatment of depression and smoking
with PLWH and demonstrated increased utilization of these medications. For this renewal, we are proposing an
implementation science test of using an algorithm that will build upon our success with CBI and integrate
alcohol pharmacotherapies and other behavioral therapies within routine treatment. A decision-tree algorithm
that provides more intensive treatments, including alcohol pharmacotherapies, that is also responsive to
comorbidities such as depressive or anxiety symptoms will be tested in three HIV clinics across CFAR Network
of Integrated Clinical Systems (CNICS). Primary outcomes include reduced alcohol consumption and
frequency, improved HIV outcomes, and improvement in comorbid conditions. We will also examine provider,
staff, patient, and clinic-level facilitators and barriers to implementation of this algorithm in routine clinical care.
Successful implementation of this treatment approach would have considerable impact on reducing AUDs
among PLWH and could be integrated within existing electronic health record systems for a sustainable model
of alcohol treatment delivery to other HIV clinics.

## Key facts

- **NIH application ID:** 10003109
- **Project number:** 5U01AA020802-10
- **Recipient organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Principal Investigator:** Karen L Cropsey
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $347,377
- **Award type:** 5
- **Project period:** 2011-09-10 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10003109

## Citation

> US National Institutes of Health, RePORTER application 10003109, 3/3 Alcohol Research Consortium in HIV - Intervention Research Arm (ARCH-IRA) (5U01AA020802-10). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10003109. Licensed CC0.

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