# Effects of experimentally-induced reductions in alcohol consumption on brain cognitive, and clinical outcomes and motivation for changing drinking in older persons with HIV infection

> **NIH NIH U01** · UNIVERSITY OF FLORIDA · 2020 · $812,853

## Abstract

This proposed U01 study will build on our past findings to determine the extent to which marked reductions in
alcohol consumption over 4-weeks via contingency management (CM) improves cognitive performance, brain
functions and pathophysiology, and HIV-associated health outcomes. HIV-associated neurocognitive
dysfunction continues even with antiretroviral treatment, and even mild cognitive impairment is associated with
detrimental health outcomes in older HIV+ adults. Alcohol consumption may affect the brain directly or
indirectly via liver toxicity and systemic inflammation. Our past findings indicate that current heavy alcohol use
is more strongly associated with cognitive/brain dysfunction among HIV+ adults than lifetime consumption,
suggesting that these effects may be reversible with reductions in drinking. Towards this objective, we propose
to enroll 180 HIV+ adults with heavy drinking, and then use CM with financial incentives and a wearable
alcohol biosensor to maximally reduce alcohol consumption from baseline (T1) to 4-weeks later (T2). We will
then conduct a motivational interview to determine perceived benefits and obstacles to drinking reduction, and
conduct a final assessment 1 year later (T3), at which point persons may or may not have resumed heavy
drinking. We will conduct state-of-the-art neuroimaging, cognitive, and behavioral assessments at each
timepoint, and then continue to track long-term drinking and HIV outcomes in our companion Cohort (U24).
The Specific Aims of this proposal are: 1) to demonstrate improved cognitive performance and brain function
(fMRI) after 4-weeks of CM-induced alcohol reduction among HIV+ adults, followed by worsening of these
effects 1-year later if heavy drinking resumes; 2) to demonstrate that cerebral metabolic (MRS) and
neuroinflammatory (DTI-free water) markers will also improve with CM-induced alcohol reduction and worsen if
drinking resumes post-CM; and 3) Determine whether perceived benefits and challenges to drinking reduction
identified during motivational interviewing (MI) predict drinking reductions or relapse one-year post-CM. We will
also determine whether changes in cerebral pathophysiology (MRS, DTI-FW) correspond with changes in
cognition, brain function (fMRI) and serum inflammatory and liver biomarkers. In addition, we will determine
which neuroimaging and baseline clinical factors are associated with long-term drinking and clinical outcomes
(e.g. HIV viral suppression, liver comorbidities). In the context of this study, CM and MI are being employed as
an experimental manipulation and data collection opportunity, respectively, rather than as clinical interventions
per se. The A-B-A design will enable us to clearly identify whether alcohol effects on cognition and the brain
are reversible, and to identify optimal strategies to promote short-term and long-term alcohol reduction in HIV+
adults. This U01 project is closely linked to the Administrative U24 (SHARC), which supports the ...

## Key facts

- **NIH application ID:** 9971409
- **Project number:** 5U01AA020797-10
- **Recipient organization:** UNIVERSITY OF FLORIDA
- **Principal Investigator:** RONALD A COHEN
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $812,853
- **Award type:** 5
- **Project period:** 2011-09-25 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9971409

## Citation

> US National Institutes of Health, RePORTER application 9971409, Effects of experimentally-induced reductions in alcohol consumption on brain cognitive, and clinical outcomes and motivation for changing drinking in older persons with HIV infection (5U01AA020797-10). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9971409. Licensed CC0.

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