Alcohol Screening, Brief Intervention, and Referral to Treatment for Nurses Working with Persons with HIV/AIDS

Purpose: Alcohol use among people living with HIV (PLWH) can have deleterious effects on health outcomes. Some of the consequences associated with alcohol use are include unsustained viral suppression, poor adherence to antiretroviral treatment (ART), increased risk taking leading to a higher likelihood of HIV transmission, increased risk for neurocognitive decline and depression, and increased mortality rates. Thus, addressing alcohol use is important for promoting the health of PLWH.

The purpose of this presentation is to illustrate a guided step-by-step intervention for nurses working with PLHW to screen, provide brief intervention and referral to treatment.

Methods: A guide published by the Center for Disease Control and Prevention served as the framework for educating nurses working with PLHW on alcohol screening and brief intervention. Educational content was developed to provide the rationale for alcohol screening and introduce the learner to established measures for screening. An algorithm was developed to guide the nurse from assessment of alcohol consumption to assessment of harm and possible alcohol use disorder and corresponding interventions. Sample scripts were written to illustrate how the nurse-patient conversation flows through the process. These conversations will focus on identifying and addressing alcohol-toxicity beliefs, and discussing the impact of alcohol use and skipping doses of ART.

Results: This content is included in a teaching and learning module for nursing students. The module is integrated in the nursing curriculum for our pre-licensure program.

Conclusion: By using the guided step-by-step intervention offered in this presentation, nurses working with PLHW can screen, provide brief intervention and referral to treatment. This evidence-based set of clinical strategies will also facilitate nurses’ engaging in a patient conversation based on the level of alcohol-related risk. These conversations will focus on identifying and addressing alcohol-toxicity beliefs, and discussing the impact of alcohol use and skipping doses of ART. The overall goal of these nurse-led interventions is to promote positive health outcomes in this population.