Population Council Research that makes a difference

Kenya National AIDS Control Council
First National Biennial HIV and AIDS Research Conference
17–20 May 2011

Abstract

"The feasibility of using HIV post-test clubs (PTC) to provide ongoing alcohol risk reduction counseling to HIV counseling and testing (HCT) clients with alcohol dependence"
Samuel Kalibala, Wanjiru Mukoma, William Sinkele, Waimar Tun, Inviolata Njeri, and Humphres Evelia

Background
Observational studies have suggested negative effects of alcohol on HIV prevention and care. A 2007 study by the Population Council; Liverpool VCT, Care & Treatment; and Support for Addiction Prevention and Treatment in Africa Centre demonstrated the feasibility of screening HCT clients for alcohol abuse, but there was a paucity of referral sites for alcohol counseling. 

Objectives
To integrate alcohol counseling in PTCs and measure uptake by HCT clients who test positive for drug dependence.

Methodology
Clients receiving HCT at 15 LVCT sites were administered the CAGE questionnaire, a four-question alcohol dependence screening test. Those who answered yes to two of the four questions were considered CAGE-positive (i.e. alcohol abusers), and were counseled briefly and referred for ongoing alcohol counseling at the PTC of that HCT center. Each PTC convened a special alcohol-counseling session every two months facilitated by an addiction counselor from SAPTA. 

Results
During May–July 2010, the sites recorded a total of 7,357 clients; 741 (10.1%) of these were CAGE-positive and referred to PTCs. Of the 741 clients, 725 were enrolled for follow-up (563 males and 162 females). Each of the 15 sites held at least the scheduled three PTC meetings, and a combined total of 56 PTC meetings during the six-month follow-up (July–December 2010). Combined PTC attendance was 174 clients for the first session, 156 for the second, and 146 for the third session. Some clients became regular attendees of the PTCs, and some PTCs were transformed into chamas (welfare groups). After the study, some of the LVCT sites have fully integrated PTC-based alcohol counseling into their services.

Conclusions
This study has shown that it is possible to provide ongoing alcohol risk-reduction counseling through HIV PTCs. Alcohol counseling should be considered a priority component of HIV programs, and PTCs should be explored to provide this service to HCT clients needing alcohol counseling.

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