The ARCH comprises three primary research components (RC), 2 resource cores, and a pilot projects component.
Research Component 1 (RC2): “Alcohol and HIV-Associated Brain Dysfunction”
Principal Investigator: Ron Cohen
RC1 is a longitudinal study that compares HIV-infected and seronegative control subjects with and without heavy alcohol use in a between-group design with repeated measures. Participants will be assessed at two time points: baseline and 18 months. Measures of neurocognitive function, and plasma measures of liver function and immunological and virologic status with respect to both HIV and hepatitis C will be obtained. Brain MRI will be also be performed at each assessment, including diffusion tensor imaging (DTI) to assess the structural integrity of the brain white matter, volumetric and cortical thickness measures from structural T1 image, and magnetic resonance spectroscopy (MRS) to determine metabolic abnormalities in key brain regions of interest. The neuroimaging and neurocognitive measures serve as the primary dependent measures.
Research Component 2 (RC2): “Brief Intervention for HIV-Infected MSM in Primary Care”
Principal Investigator: Christopher Kahler
RC2 is a randomized clinical trial in which 180 heavy drinking men who have sex with men (MSM), who receive their HIV primary care at Fenway Health in Boston, are randomly assigned to treatment as usual (TAU) or TAU plus a brief intervention to reduce alcohol use (TAU-BI). TAU-BI is based on MI and includes personalized feedback tailored to an HIV-infected MSM population. TAU-BI includes a single 60-minute session at baseline and booster sessions in-person at 3 and 6 months. Follow-up assessments extend 12 months past baseline. The first primary aim of the study is to test the hypothesis that TAU-BI, compared to TAU, will result in reduced alcohol consumption over a 12-month follow-up period. Reductions in high-risk sexual behavior and increased adherence to HAART are secondary outcomes along with change in CD4 lymphocyte counts and HIV RNA.
Research Component 3 (RC3; 5R01AA009892): “Brief Interventions in the Emergency Department for Alcohol and HIV/Sexual Risk”
Principal Investigator: Peter Monti
RC3 tests whether a single-session multiple risk Motivational Interview (MI) can more effectively decrease and maintain reduction in alcohol use, alcohol related problems, and sexual risk taking following discharge from the ED than Brief Advice (BA). Baseline, MI, and BA are administered in the ED. Follow-ups will be conducted at 3, 6 and 9 months. In addition, this study addresses potential mediators (motivation to change risk taking, self-efficacy) of MI effects and whether reductions in sexual risk associated with MI compared to BA are accounted for by reduced drinking. The cost-effectiveness of the interventions will also be addressed.
Minority Populations Resource Core (U24AA022000)
Principal Investigator: Don Operario
This purpose of this project is to develop a Minority Populations Resource Core within the Brown University Alcohol Research Center on HIV. The core conducts theory-driven analyses and supports investigations on the co-occurrence of HIV risk and alcohol use, and other health challenges, among sexual minority populations in the United States.
Mechanisms of Behavior Change Resource Core for Alcohol-HIV Interventions (U24 AA022003)
Principal Investigator: Christopher Kahler
This project supports a resource core that is coding clinical dialogues in five alcohol-HIV intervention trials to assess mechanisms of behavior change in both alcohol use and HIV-related behaviors such as HAART adherence, sexual risk behavior, and acceptance of alcohol pharmacotherapy.
Pilot Project 1: "Imaging Functional Alcohol Effects in HIV"
Principal Investigator: Tara White, PhD
Pilot 1 analyzes the impact of alcohol and HIV on functional brain responses to an acute dose of alcohol over the biphasic time course of its effects. The study aims to provide new information about the functional impact of alcohol in response to a moderate acute dose of alcohol (0.6) which is routinely consumed by HIV+ heavy drinkers in the real-world that can have direct application in dissemination efforts to reduce alcohol use in this population.
Pilot Project 2: “Molecular Characteristics of Occult HBV Strains from HIV+ Women with Alcohol Abuse”
Principal Investigator: Jack Wands, MD
Pilot Project 2 aims to provide molecular virologic information on the impact of occult hepatitis B infection and alcohol on the process of progressive severe liver disease in women with chronic HIV infection.
Pilot Project 3: "Alcohol and HIV Risk-taking among Fishermen and Commercial Sex Workers in Uganda"
Principal Investigator: Susan Kiene, PhD
Dr. Kiene is currently funded by a K01 from NIMH that focuses on adapting an efficacious intervention for reducing risky sexual behavior to a primary prevention setting in Uganda. Her Pilot Project enables her to extend her research in a new population and region in Uganda.