Does Reducing Alcohol Use Among People with HIV Alleviate Psychological Distress and Symptoms of Depression? A Randomized Controlled Trial in Tshwane, South Africa

Although alcohol use is associated with depression, it is unclear if brief alcohol reduction interventions can ameliorate depression and psychological distress among people with HIV (PWH). We use data from a two-arm randomised controlled trial to examine this question. PWH on antiretroviral treatment (ART) were randomly assigned to receive a brief intervention or treatment as usual (n = 622). Screening was done with the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-C, Centre for Epidemiological Studies Depression inventory and Kessler Psychological Distress Scale, at baseline and at 3- and 6-months post-baseline. Changes in depression and psychological distress was assessed using analysis of covariance models with baseline measures of alcohol consumption, sex and age included as covariates and adjusting for baseline symptom severity. Changes in alcohol consumption between baseline and follow-up were included in the analysis to establish if this affected outcomes. For both the intervention and control groups, there were significant reductions in symptom severity at 3-months and 6-months for depression and psychological distress, but no significant between group differences were observed. Reductions in alcohol consumption were significantly associated with reductions in depression and psychological distress, supporting the hypothesis that alcohol use is linked to depression among PWH. Trial Registration Pan African Clinical Trials Register, PACTR201405000815100.nh