Please select the eligibility criteria that correspond to the clinical trial below.
Title: "Effectiveness of a Brief Intervention for Substances Consumption Linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): A Randomized Control Trial in Chilean Primary Care."
Brief Summary: Alcohol and drugs consumption are among the highest risk factor for health in Chile and abroad. In Chile, harmful use of alcohol continues to be a major contributor to the burden of disease while lost years of healthy life are higher than many other risk factors such as hypertension, overweight and obesity, and hyperglycemia. It is important to say that the impact of alcohol consumption is greater in younger age groups where fatal injuries occur relatively early in life, as well.

In Chile, the consumption pattern in 2008 showed that 49.8 % consumed at least once in the last month for alcohol, 3.5 % for marihuana and 1.3 % for cocaine. This prevalence was even greater in young adults and adolescents and is associated with other mental health issues and poorer life quality. Those who have consumed marihuana during the last year, 25% report dependence symptoms. For cocaine derives, dependency rises up to 50% among the consumers. This data reinforce the need to design and implement strategies for reducing alcohol and drugs consumption in our population.

Also, it is well known that a high number of those who suffers from any addiction problem do not get attention in a specialized center. The are many barriers to do so, such as lack of motivation, lack of resources, social problems, access to care problems, and so on.

Chile has a shortage of preventive interventions for those at risk to develop an addiction at an early stage of substance use because front line health services (Primary health care and emergency care) and other social services (police stations, local justice courts) do not have a screening system and a model of brief intervention.

The Pontificia Universidad Catolica de Chile, through its Addiction Studies Center (CEDA UC) and its Department of Family Medicine, is working in conjunction with SENDA (Servicio Nacional para la Prevención y Rehabilitación del Consumo de Drogas y Alcohol ) to design, implement and evaluate a communal system for early detection, brief intervention and referral to treatment (SBIRT), in people older than 18 years, with substance consumption in five municipalities in the country.

The aid of this study is to demonstrate that a model of brief intervention is more effective than the approach currently used in patients with substance use at moderate risk (i.e.follow-up). It is a multicentric randomized controlled trial, single blind, with a group to receive brief intervention and a control group that is kept in control and waiting list being re-evaluated three months later.

The target population is composed by users whose ASSIST screening scores place them in the moderate risk group, for which there has not been defined a structured intervention yet by our health system. The information will be obtained from the scores obtained after the application of the ASSIST-WHO questionnaire.


Options:
A: Inclusion Criteria:

* Men and women older than 18 years and 50 years
* Achieving a moderate risk score in the ASSIST screening questionnaire.
* Without any similar intervention in the last 3 months. (ie. AUDIT test).

Exclusion Criteria:

* Pregnant women.
* Users with cognitive disabilities.
* Users with language and communication disabilities.
B: Inclusion Criteria:

* Female sex worker, defined as a woman who self reports exchange of any type of sex including oral, anal, and vaginal sex for money or gifts within the six months prior to study enrollment;
* Self-identifies as a woman;
* 18 years or older;
* Scores between 7-19 on the AUDIT questionnaire;
* Willing to participate in the study and all data collection procedures;
* Lives in Mombasa or plans on residing in Mombasa for 12 months following study enrollment;
* Currently participating in the APHIA II sex worker peer education program; and
* Documentation of negative tests for gonorrhea, Chlamydia, and trichomoniasis.

Exclusion Criteria:

* Scores less than 7 (low-risk drinking) or more than 19 (high-risk drinking/alcohol dependence) on the AUDIT questionnaire;
* Plans to be away in the next 12 months for more than six months or relocate away from the study site;
* Currently participating in another HIV intervention study; or
* Has any other condition that, in the opinion of the investigator or designee, would preclude provision of informed consent, make participation in the study unsafe, complicate interpretation of study outcome data, or otherwise with achieving the study objectives.
C: Inclusion Criteria:

* Initial inclusion criteria for overall enrollment (into either the Cohort or RCT study) will be:

  * HIV positive
  * Receiving HIV treatment services at one of the two study clinics
  * Current hazardous alcohol use, defined as an AUDIT score of ≥8 for men and ≥ 4 for women
  * Provides informed consent

Secondary inclusion for enrollment into the RCT will be:

* AUDIT scores that indicate a moderate-to-severe AUD (≥12 for women; ≥16 among men)
* AND/OR: meeting validated symptom criteria for depression (≥16 on Center for Epidemiological Studies-Depression (CES-D), trauma/anxiety (≥2.5 on HTQ), and/or substance use (≥27 for any non-tobacco/alcohol substance on ASSIST)

Exclusion Criteria:

* HIV negative
* Not receiving care at one of the study clinics
* Currently psychotic or actively suicidal
* Unable to provide informed consent
D: Inclusion Criteria:

* 18 years or older, pregnant, and HIV+
* Enrolled in the PMTCT program at the study site clinic
* Receiving medical care from study site clinic
* Residing in study area for duration of study
* No psychosis, neurological damage, or IQ less than 70, as judged by an interviewer in consultation with a clinical supervisor
* Ability to give informed consent as judged by an interviewer

Exclusion Criteria:

* Less than 18 years, or not pregnant, or not HIV+
* Not enrolled in the PMTCT program at the study site clinic
* Not receiving medical care from study site clinic
* Not residing in study area for duration of study
* Psychosis, neurological damage, or IQ less than 70, as judged by an interviewer in consultation with a clinical supervisor
* Clinical provider (nurse or physician) believes it is not in the best interest of the MLH
* Unable to give informed consent

Answer: A