# Hybrid trial for Alcohol reduction among people with TB and HIV in India (HATHI)

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2024 · $114,088

## Abstract

In 2021, there were 2.4 million persons living with HIV (PWH) in India and 63,000 new HIV infections. Among
PWH in India, 65% are on antiretroviral therapy (ART) and 55% are virally suppressed. Unhealthy alcohol use,
encompassing heavy/hazardous use, binge drinking and alcohol use disorders (AUD), is on the rise in India
and is a barrier to HIV treatment as prevention (HIV TASP) success. Furthermore, PWH’s unhealthy alcohol
use is associated with HIV transmission, decreased use of and adherence to ART, lower viral suppression,
decreased engagement and retention in care, more rapid disease progression, and mortality. Given the
increased risk for adverse HIV outcomes, unhealthy alcohol use is an important but neglected modifiable risk
factor for morbidity and mortality among PWH. In a hybrid effectiveness-implementation study, R01AA027972
“Hybrid trial for alcohol reduction among people with TB and HIV in India (HATHI)”, we are funded to test a
behavioral alcohol reduction intervention that incorporates cognitive behavioral (CBT) and motivational
enhancement therapy (MET) among persons with tuberculosis (TB) and TB/HIV co-infection in Pune, India. We
have culturally adapted an evidence-based intervention and initiated recruitment in September 2022 at BJGMC
and Dr. D.Y Patil Medical College. We are recruiting people from both TB and HIV clinics. In our first ten
months of alcohol screening in HIV clinics with the AUDIT, 437 PWH met criteria for unhealthy alcohol use who
were not TB co-infected. Given that unhealthy alcohol use contributes to poor outcomes among PWH and is a
major barrier to global initiatives to end the HIV pandemic, excluding individuals with HIV only is a missed
opportunity to see if this evidence-based intervention can also improve outcomes among PWH only. In this
administrative supplement to HATHI, we propose to extend our inclusion criteria to PWH without TB. We will
recruit 150 PWH and unhealthy alcohol use from our two Pune HIV ART clinics. and randomize them to our
CBT/MET-based HATHI intervention or standard of care. The intervention consists of four counseling sessions
followed by three boosters, integrated into HIV care. Effectiveness outcomes measured at 3, 6 and 12 months
include 1) self-reported alcohol use and phosphatidyl ethanol, an alcohol biomarker, and 2) HIV clinical
outcomes (HIV RNA suppression and ART adherence). Using the RE-AIM implementation framework, we will
use mixed methods to assess barriers and facilitators to alcohol treatment integration in HIV clinical settings
and the incremental costs of this intervention strategy. This supplement provides an opportunity to examine
whether our adapted intervention will effectively reduce unhealthy alcohol use among PWH in India. We have
trained counselors in the intervention delivery, developed systems for fidelity monitoring, and developed our
database and procedures. Leveraging resources and infrastructure of HATHI through this supplement will
increase efficie...

## Key facts

- **NIH application ID:** 10976745
- **Project number:** 3R01AA027974-04S1
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** GEETANJALI CHANDER
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $114,088
- **Award type:** 3
- **Project period:** 2020-09-05 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10976745

## Citation

> US National Institutes of Health, RePORTER application 10976745, Hybrid trial for Alcohol reduction among people with TB and HIV in India (HATHI) (3R01AA027974-04S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10976745. Licensed CC0.

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