Project HERMITAGE: HIV Prevention in Hospitalized Russian Drinkers
Condition: HIV Infections
MeSH terms: HIV Infections
Study type: Interventional

Summary: 
      The objective of this study is to test in a randomized controlled trial the effectiveness of
      a US secondary HIV prevention program to reduce HIV risk behaviors, STD acquisition, and
      alcohol consumption among HIV-infected Russians with risky drinking.
    

Detailed description: 
      Russia has one of the fastest growing AIDS epidemics in the world, with an estimated 1
      million HIV-infected persons. Initially the Russian HIV epidemic was almost exclusively among
      injection drug users (IDUs); however, concern exists that HIV is expanding into the general
      population via sexual transmission. Alcohol use, highly prevalent in Russia, may increase
      high-risk sexual behaviors among IDUs and alcohol dependent persons. Furthermore, animal
      models suggest that alcohol consumption plays a permissive role for HIV replication as the
      resultant higher viral loads may increase risk of transmission. Thus alcohol use may
      accelerate HIV transmission to the general population in Russia.

      The study will randomize 700 HIV-infected patients with risky alcohol consumption to an
      adapted Healthy Relationships Intervention (HRI) or attention-control support groups. The
      intervention will be culturally adapted and modified to address substance use and associated
      risk behaviors. Subjects participating in the HRI will attend three 90-120 min structured
      group sessions in addition to two 30-60 min individualized sessions over the course of 5-10
      days. Subjects in the attention-control group will participate in general health information
      sessions in the same format (i.e., 2 individualized and 3 group sessions) during the same
      timeframe.

      All patients will be assessed at baseline (pre-randomization) and 6-months and 12-months
      post-randomization at the recruitment site. Primary outcomes are HIV sex and drug risk
      behaviors and sexually transmitted diseases. Additionally, subjects will be assessed
      regarding secondary outcomes including alcohol consumption, quality of life and social
      support, victimization, suicide, overdose, and disclosure of HIV serostatus.

      We hypothesize that relative to the comparison group, participants receiving the adapted
      Healthy Relationships Intervention will have reduced HIV sex and drug risk behaviors and STD
      acquisition. If the intervention is effective among HIV-infected hospitalized patients, it
      could be used to address other HIV infected persons in a variety of Russian settings
      potentially reducing the transmission of HIV by decreasing risky sex and drug use behaviors
      among Russians.
    

Intervention name(s): Individual and group HIV risk behavior counseling sessions; health education and support group
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Healthy Relationships Intervention (HRI) culturally adapted and modified to address substance use and associated risk behaviors; subjects will attend three 2-hour structured group sessions in addition to two 1-hour individualized sessions over the course of 10 days.; general health information (nutrition, stress reduction) in 2 individual sessions and 3 group sessions.
Other intervention name(s): HRI
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: HIV; Unsafe sex; High-risk sex; Needle sharing; STDs