Impact of multilevel interventions on reducing reasons for drinking among men living with HIV

Alcohol use is prevalent among people living with HIV and poses a significant barrier to antiretroviral therapy (ART) adherence. This study evaluated the effectiveness of multilevel interventions in addressing the underlying reasons for drinking among men with HIV receiving ART in India. This secondary analysis of a randomized trial in Mumbai assessed the impact of counseling, group interventions, and advocacy on alcohol use. Participants completed surveys on demographic characteristics, reasons for drinking, HIV stigma, ART adherence, depressive symptoms, family support, and CD4 count at multiple time points. Mixed-effect models were used to evaluate intervention effects. At baseline, participants in the intervention group reported more reasons for drinking than those in the control group. Over time, the intervention group showed significant reductions in reasons for drinking, with odds decreasing by 61.3% at Visit 2, 90.5% at Visit 3, and 86.2% at Visit 4 compared to the control group (p <.001). Findings suggest that repeated exposure to intervention components plays a crucial role in sustaining behavioral change. Multilevel interventions integrating individual, group, and community-based approaches may effectively reduce alcohol use among men with HIV, with potential benefits for improving ART adherence and overall health outcomes. Trial registration: ClinicalTrials.gov identifier: NCT03746457.