Systematic cultural adaptation of cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in Western Kenya

Rebecca K. Papas; John E. Sidle; Steve Martino; Joyce B. Baliddawa; Rogers Songole; Otieno E. Omolo; Benson N. Gakinya; Michael M. Mwaniki; Japheth O. Adina; Tobista Nafula; Willis D. Owino-Ong'Or; Kendall J. Bryant; Kathleen M. Carroll; Joseph L. Goulet; Amy C. Justice; Stephen A. Maisto

doi:10.1007/s10461-009-9647-6

Systematic cultural adaptation of cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in Western Kenya

Rebecca K. Papas, John E. Sidle, Steve Martino, Joyce B. Baliddawa, Rogers Songole, Otieno E. Omolo, Benson N. Gakinya, Michael M. Mwaniki, Japheth O. Adina, Tobista Nafula, Willis D. Owino-Ong'Or, Kendall J. Bryant, Kathleen M. Carroll, Joseph L. Goulet, Amy C. Justice, Stephen A. Maisto

Department of Psychology

Research output: Contribution to journal › Article › peer-review

57 Scopus citations

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.

Original language	English (US)
Pages (from-to)	669-678
Number of pages	10
Journal	AIDS and Behavior
Volume	14
Issue number	3
DOIs	https://doi.org/10.1007/s10461-009-9647-6
State	Published - Jun 2010

Keywords

Alcohol
Cognitive behavioral therapy
Cultural adaptation
HIV
Kenya

ASJC Scopus subject areas

Social Psychology
Public Health, Environmental and Occupational Health
Infectious Diseases

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10.1007/s10461-009-9647-6

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Papas, R. K., Sidle, J. E., Martino, S., Baliddawa, J. B., Songole, R., Omolo, O. E., Gakinya, B. N., Mwaniki, M. M., Adina, J. O., Nafula, T., Owino-Ong'Or, W. D., Bryant, K. J., Carroll, K. M., Goulet, J. L., Justice, A. C., & Maisto, S. A. (2010). Systematic cultural adaptation of cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in Western Kenya. AIDS and Behavior, 14(3), 669-678. https://doi.org/10.1007/s10461-009-9647-6

Papas, RK, Sidle, JE, Martino, S, Baliddawa, JB, Songole, R, Omolo, OE, Gakinya, BN, Mwaniki, MM, Adina, JO, Nafula, T, Owino-Ong'Or, WD, Bryant, KJ, Carroll, KM, Goulet, JL, Justice, AC & Maisto, SA 2010, 'Systematic cultural adaptation of cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in Western Kenya', AIDS and Behavior, vol. 14, no. 3, pp. 669-678. https://doi.org/10.1007/s10461-009-9647-6

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title = "Systematic cultural adaptation of cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in Western Kenya",

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.",

keywords = "Alcohol, Cognitive behavioral therapy, Cultural adaptation, HIV, Kenya",

author = "Papas, {Rebecca K.} and Sidle, {John E.} and Steve Martino and Baliddawa, {Joyce B.} and Rogers Songole and Omolo, {Otieno E.} and Gakinya, {Benson N.} and Mwaniki, {Michael M.} and Adina, {Japheth O.} and Tobista Nafula and Owino-Ong'Or, {Willis D.} and Bryant, {Kendall J.} and Carroll, {Kathleen M.} and Goulet, {Joseph L.} and Justice, {Amy C.} and Maisto, {Stephen A.}",

note = "Funding Information: Acknowledgments This research was sponsored by NIAAA-funded R21AA016884, NIDA-funded P50DA09241 and supported in part by a grant to the USAID-AMPATH Partnership from the United States Agency for International Development as part of the President{\textquoteright}s Emergency Plan for AIDS Relief. We acknowledge Emmanuel Wamalwa and Serah Chepseba for their assistance with data collection. We also thank Robert Skipworth Comer from the Indiana University School of Informatics for the contribution and development of locally relevant CBT illustrations. Finally, we extend our appreciation to Chematics, Inc. of North Webster, Indiana for the generous donation of alcohol saliva tests for this project.",

year = "2010",

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doi = "10.1007/s10461-009-9647-6",

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AU - Papas, Rebecca K.

AU - Sidle, John E.

AU - Martino, Steve

AU - Baliddawa, Joyce B.

AU - Songole, Rogers

AU - Omolo, Otieno E.

AU - Gakinya, Benson N.

AU - Mwaniki, Michael M.

AU - Adina, Japheth O.

AU - Nafula, Tobista

AU - Owino-Ong'Or, Willis D.

AU - Bryant, Kendall J.

AU - Carroll, Kathleen M.

AU - Goulet, Joseph L.

AU - Justice, Amy C.

AU - Maisto, Stephen A.

N1 - Funding Information: Acknowledgments This research was sponsored by NIAAA-funded R21AA016884, NIDA-funded P50DA09241 and supported in part by a grant to the USAID-AMPATH Partnership from the United States Agency for International Development as part of the President’s Emergency Plan for AIDS Relief. We acknowledge Emmanuel Wamalwa and Serah Chepseba for their assistance with data collection. We also thank Robert Skipworth Comer from the Indiana University School of Informatics for the contribution and development of locally relevant CBT illustrations. Finally, we extend our appreciation to Chematics, Inc. of North Webster, Indiana for the generous donation of alcohol saliva tests for this project.

PY - 2010/6

Y1 - 2010/6

N2 - 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.

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KW - Cultural adaptation

KW - HIV

KW - Kenya

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Systematic cultural adaptation of cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in Western Kenya

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