Evaluation of a Combined Motivational Interviewing and Ecological Momentary Intervention to Reduce Risky Alcohol Use among Individuals Vulnerable to HIV/AIDS

Among emerging adults at high risk for HIV, hazardous alcohol use can increase the risk of engaging in HIV risk behaviors. One method of reducing hazardous alcohol use is motivational interviewing, which has been effective among various populations in prior literature and the investigators’ pilot research. Technology can help to extend the impact of this approach by delivering messaging to prevent risk behaviors in real time (i.e., outside of intervention sessions). This study will conduct a 3-arm randomized controlled trial that assesses the efficacy of two interventions compared to a control: 1) A 4-week motivational interviewing intervention (TRAC) delivered remotely via cell phones and 2) TRAC combined with an ecological momentary intervention that delivers messages reinforcing drinking reduction strategies discussed during TRAC sessions when individuals visit risky locations (TRAC-ER). All participants will also monitor alcohol use and sexual behavior via daily surveys and twice-daily mobile breathalyzer readings. TRAC-ER will use an app that uses GPS tracking to determine when individuals visit “risky” locations. Participants will receive messages upon arrival at these locations reminding them of strategies to address drinking triggers and will complete surveys and breathalyzers when they leave to determine what alcohol and/or risk behaviors they engaged in. If they reported drinking, they receive harm reduction messaging to encourage them to avoid subsequent risk behavior. Breathalyzer results and daily self-reports will be used to assess the primary outcomes of drinking days, drinks/drinking day, binge drinking episodes, and HIV risk behaviors, and additional assessments over 8 months will evaluate long-term outcomes. Participants will be recruited from Kentucky and Connecticut through community-based recruitment and health clinics that provide HIV/STI prevention services.