# Mobile technology to extend clinic-based counseling for HIV+s in Uganda

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2020 · $312,806

## Abstract

Abstract
Alcohol consumption is a critical predictor of poor HIV outcomes such as reduced antiretroviral adherence and
lack of viral suppression. Reducing unhealthy alcohol use among those with HIV may improve HIV outcomes
and thus is a high priority. HIV prevalence and unhealthy drinking rates are high in sub-Saharan Africa (SSA).
Multi-session approaches to screening and brief counseling have good evidence for reducing alcohol use in
resource rich settings and in persons with HIV. However, multiple in-person sessions are costly and unlikely to
be scalable in SSA. Thus, there is a need to develop and test low-cost alternatives. A successful multi-contact
alcohol intervention studied in the US uses phone-based booster sessions with a live counselor (“live
boosters”) to reinforce the content of two brief in-person sessions. Because cell phone coverage is widespread
in SSA, an intervention that uses live boosters may be feasible, particularly if the in-person sessions coincide
with regular clinic visits. However, live booster calls can be labor intensive and dependent on a good phone
network. Alternatively, automated booster sessions can be conducted via cell phone using short message
service (SMS, i.e. text) or interactive voice response (IVR) systems, to provide brief 2-way interactive sessions
(“tech boosters”). These systems are likely to be at low cost and burden to providers and patients. The
SMS/IVR systems allow for tailoring the 2-way booster sessions on variables such as gender and drinking
goals. The primary aims of this developmental study are (1) To adapt a successful alcohol intervention for
unhealthy drinkers with HIV in Uganda to include in-person sessions that coincide with two routine quarterly
clinic visits, with live booster calls delivered between in-person sessions, and to develop tech boosters as a
scalable alternative to live calls. We will collect qualitative data via focus group discussions and individual in-
depth interviews to elicit community and patient input into the content and delivery of the interventions. (2) To
conduct a pilot randomized controlled trial (RCT) to test these methods for unhealthy drinkers in HIV care in
rural Uganda (n=270). The study arms will be: (a) in-person counseling during 2 quarterly clinic visits plus live
booster calls every 3 weeks in the interim, (b) in-person counseling during 2 quarterly clinic visits plus twice
weekly tech (choice of SMS or IVR) boosters in the interim, and (c) standard of care control (brief unstructured
advice, with a wait-listed intervention). We will obtain preliminary estimates of uptake, acceptability, cost, and
efficacy in reducing alcohol use and decreasing viral failure for each study arm at six months. We will utilize an
alcohol biomarker, phosphatidylethanol, in addition to self-reported alcohol use, and measure viral suppression
via dried blood spots. This study will be conducted in a large rural Ugandan HIV clinic where we have 10 years
of collaborating...

## Key facts

- **NIH application ID:** 9906836
- **Project number:** 5R01AA024990-04
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Judith Alissa Hahn
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $312,806
- **Award type:** 5
- **Project period:** 2017-04-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9906836

## Citation

> US National Institutes of Health, RePORTER application 9906836, Mobile technology to extend clinic-based counseling for HIV+s in Uganda (5R01AA024990-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9906836. Licensed CC0.

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