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Cultural Adaptation of an Intervention to Reduce Hazardous Alcohol Use Among People Living with HIV in Southwestern Uganda


Hazardous drinking by persons living with HIV (PLHIV) is a well-established determinant of sub-optimal HIV care and treatment outcomes. Despite this, to date, few interventions have sought to reduce hazardous drinking among PLHIV in sub-Saharan Africa (SSA). We describe an iterative cultural adaptation of an evidence-based multi-session alcohol reduction intervention for PLHIV in southwestern Uganda. The adaptation process included identifying core, theoretically informed, intervention elements, and conducting focus group discussions and cognitive interviews with community members, HIV clinic staff and patients to modify key intervention characteristics for cultural relevance and saliency. Adaptation of evidence-based alcohol reduction interventions can be strengthened by the inclusion of the target population and key stakeholders in shaping the content, while retaining fidelity to core intervention elements.

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Data Availability

Data will be made available upon request to the investigators Hahn, Camlin, and Muyindike.

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We would like to thank the participants who engaged in this study. We gratefully acknowledge the Uganda Ministry of Health, Mbarara University of Science and Technology (MUST), Mbarara Regional Referral Hospital, the staff of the Mbarara Immune Suppression Syndrome Clinic, our research and administrative teams at MUST and UCSF. We would also like to acknowledge the study counselors David Mugumya and Frances Musinguzi.


This research was supported by the National Institutes of Health (NIH) through the National Institute on Alcohol Abuse and Alcoholism (NIAAA) with grants R01AA024990 (PI: Hahn) and K24022586 (PI: Hahn). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health.

Author information




Judith A. Hahn, Carol S. Camlin, Winnie R. Muyindike, Heidi E. Hutton, Geetanjali Chander and Sarah E. Woolf-King contributed to the study conception and design. Material preparation, data collection and analysis were performed by Carol S. Camlin, Judith A. Hahn, Winnie R. Muyindike, Sarah E. Woolf-King, Monica Getahun, Nneka I. Emenyonu, Naomi Sanyu, Anita Katusiime and Robin Fatch. The first draft of the manuscript was written by Anna M. Leddy and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Anna M. Leddy.

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Ethical Approval

This study received ethical approval from the University of California San Francisco Institutional Review Board (IRB), the Mbarara University of Science and Technology Research and Ethics Committee, and the Uganda National Council on Science and Technology.

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All participants provided informed consent.

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Leddy, A.M., Hahn, J.A., Getahun, M. et al. Cultural Adaptation of an Intervention to Reduce Hazardous Alcohol Use Among People Living with HIV in Southwestern Uganda. AIDS Behav 25, 237–250 (2021).

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  • Cultural adaptation
  • Alcohol reduction
  • Evidence-based interventions
  • People living with HIV
  • Uganda
  • Sub-saharan africa