Abstract:
Two-thirds of those with HIV worldwide live in sub-Saharan Africa. Alcohol use is associated with
the HIV epidemic through risky sex and suboptimal ARV adherence. In western Kenya, hazardous
drinking was reported by HIV (53%) and general medicine (68%) outpatients. Cognitive behavioral
treatment (CBT) has demonstrated strong efficacy to reduce alcohol use. This article reports on a
systematic cultural adaptation and pilot feasibility study of group paraprofessional-delivered CBT
to reduce alcohol use among HIV-infected outpatients in Eldoret, Kenya. Following adaptation and
counselor training, five pilot groups were run (n=27). Overall attendance was 77%. Percent days
abstinent from alcohol (PDA) before session 1 was 52%–100% (women) and 21–36% (men), and
by session 6 was 96%–100% (women) and 89%–100% (men). PDA effect sizes (Cohen’s d) between
first and last CBT session were 2.32 (women) and 2.64 (men). Participants reported treatment
satisfaction. Results indicate feasibility, acceptability and preliminary efficacy for CBT in Kenya
