Feasibility of SBIRT-PN
Condition: Substance Use; HIV/AIDS; Older Adults; Behavioral Intervention; Infectious Disease
MeSH terms: Communicable Diseases; Infections; Substance-Related Disorders
Study type: Interventional

Summary: 
      Substance misuse is a common problem among HIV+ individuals. Research suggests that a
      Screening, Brief Intervention, and Treatment (SBIRT) model can be effective in reducing
      substance misuse in the general older adult population; however these findings have not been
      verified in the more vulnerable HIV+ older adult population. The present study seeks to
      address the problem of substance misuse in older HIV+ adults by piloting a SBIRT model for
      older HIV+ adults in a in a primary care setting. Individual reductions in alcohol and drug
      use can have significant effects on public health and safety when observed over a large
      population at risk for substance use problems. With wider dissemination statewide, a
      relatively low-cost intervention such as SBIRT could offer demonstrated benefits in this
      population.
    

Detailed description: 
      The current project will pilot SBIRT with a peer navigator (SBIRT-PN) versus treatment at
      usual (TAU) to increase substance use treatment engagement among HIV-positive adults aged 50
      years and older. The investigators will recruit patients from the Southern HIV and Alcohol
      Research Consortium (SHARC) HIV primary care clinic network.

      In order to develop effective substance use intervention models for HIV care settings the
      specific aims of the current project are:

      Aim1: Examine the feasibility of the SBIRT-PN model at the UF Health Infectious
      Disease-Medical Specialties Clinic. The investigators hypothesize that the SBIRT-PN model
      will demonstrate high feasibility within the UF Health Infectious Disease - Medical
      Specialties Clinic.

      Aim2a: Assess the acceptability of SBIRT-PN. The investigators hypothesize that SBIRT-PN will
      demonstrate high acceptability among patients enrolled in this condition.

      Aim2b: Assess the acceptability of SBIRT-PN among HIV-positive individuals by age cohort
      (younger vs older). The investigators hypothesize that SBIRT-PN will demonstrate higher
      acceptability among older HIV-positive patients enrolled in this condition.

      Aim3: Assess influence of SBIRT-PN model on treatment engagement and substance use compared
      to enhanced treatment as usual (TAU).The investigators hypothesize that those in the SBIRT-PN
      condition will evidence greater treatment engagement and a reduction in substance use.
    

Intervention name(s): Psycho-educational content (5 Minutes); Readiness Assessment (10 minutes); Goal-Setting (5 minutes); Identifying and prioritizing needs (5 minutes); Explanation of Peer Navigator and Session wrap (5 minutes)
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral; Behavioral
Intervention description(s): The interventionist will discuss substance use and misuse and the influence of substance use on self care.; The interventionist will give the patient feedback on their ASSIST score and assess the patient's readiness to change based on Prochaska's stages of change.; The interventionist will use motivational interviewing techniques to identify the patients' most salient reasons for addressing substance use issues.; The interventionist will use problem-solving techniques to help patients identify which services may best help them work towards their goals. Services will include (but are not limited to) emergency crisis services, counseling to deal with substance use, referral to local self-help groups (Alcoholics Anonymous, Narcotics Anonymous, etc.), legal assistance, faith-based counseling, mental health counseling or inpatient substance use treatment.; The interventionist will use a referral resource guide to provide the contact information of agency representatives and help the patient formulate a plan for follow-up.
Other intervention name(s): Prochaska's stages of change.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A repeated measures randomized control trial design to compare patient outcomes at baseline as well as 3 and 6 months post-intervention
Masking: Single (Participant)
Primary purpose: Screening