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ReACH2Gether: Iterative Development of a Couples-Based Intervention to Reduce Alcohol use Among Sexual Minority Men Living with HIV and Their Partners

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Abstract

Unhealthy alcohol use, which encompasses heavy episodic drinking to alcohol use disorder, has been identified as a modifiable barrier to optimal HIV care continuum outcomes. Despite the demonstrated efficacy of couples-based interventions for addressing unhealthy alcohol use, there are no existing couples-based alcohol interventions designed specifically for people living with HIV. This study presents the development and refinement of a three-session couples-based motivational intervention (ReACH2Gether) to address unhealthy alcohol use among a sample of 17 sexual minority men living with HIV and their partners living in the United States. To increase potential population reach, the intervention was delivered entirely remotely. Throughout an original and a modified version, results indicated that the ReACH2Gether intervention was acceptable and there were no reports of intimate partner violence or adverse events. Session engagement and retention were high. In pre-post-test analyses, the ReACH2Gether intervention showed trends in reducing Alcohol Use Disorder Identification Test scores and increasing relationship-promoting dynamics, such as positive support behaviors and goal congruence around alcohol use. Results support the need for continued work to evaluate the ReACH2Gether intervention.

Resumen

El consumo no saludable de alcohol, que abarca episodios intensos de consumo hasta llegar a causar trastornos de alcohol, se ha identificado como una barrera modificable para los resultados óptimos continuos de la atención del VIH. A pesar de la eficacia demostrada de las intervenciones basadas en parejas para abordar el consumo no saludable de alcohol, no existen intervenciones de alcohol basadas en parejas diseñadas específicamente para personas que viven con el VIH. Este estudio presenta el desarrollo y perfeccionamiento de una intervención motivacional basada en parejas de tres sesiones (ReACH2Gether) para abordar el consumo no saludable de alcohol entre una muestra de 17 hombres de minorías sexuales que viven con el VIH y sus parejas que viven en los Estados Unidos. Para aumentar el alcance de la población potencial, la intervención se realizó de forma totalmente remota. A lo largo de una versión original y modificada, los resultados indicaron que la intervención ReACH2Gether era aceptable y no hubo informes de violencia de pareja o eventos adversos. El compromiso y la retención de la sesión fueron altos. En los análisis previos y posteriores a la prueba, la intervención ReACH2Gether mostró tendencias en la reducción de las puntuaciones de la prueba de identificación del trastorno por consumo de alcohol y en el aumento de las dinámicas que promueven las relaciones, como comportamientos de apoya positivas y congruencia de objetivos en torno al consumo alcohol. Los resultados respaldan la necesidad de un trabajo continuo para evaluar la intervención ReACH2Gether.

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Acknowledgements

The authors would like to thank the men who participated in this study. This study was funded by a grant from the National Institute on Alcohol Abuse and Alcoholism (R34AA024703) and was supported in part by grants from the National Institutes of Health (U24AA022003, P01AA019072, P30MH062246, P20GM130414).

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Authors and Affiliations

  1. Deparment of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA

    Kristi E. Gamarel

  2. Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA

    Ayla Durst, David G. Zelaya, Timothy Souza, Peter M. Monti & Christopher W. Kahler

  3. Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA

    David G. Zelaya, Peter M. Monti & Christopher W. Kahler

  4. Department of Psychiatry, Harvard Medical School, Boston, MA, USA

    David G. Zelaya

  5. Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA

    Jacob J. van den Berg

  6. Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA

    Mallory O. Johnson

  7. Social Intervention Group, Columbia University School of Social Work, New York, NY, USA

    Elwin Wu

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  1. Kristi E. Gamarel
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  2. Ayla Durst
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Correspondence to Kristi E. Gamarel.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Gamarel, K.E., Durst, A., Zelaya, D.G. et al. ReACH2Gether: Iterative Development of a Couples-Based Intervention to Reduce Alcohol use Among Sexual Minority Men Living with HIV and Their Partners. AIDS Behav 28, 1244–1256 (2024). https://doi.org/10.1007/s10461-023-04148-3

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