Combining rapid HIV testing and a brief alcohol intervention in young unhealthy drinkers in the emergency department:...

We sought to determine the feasibility and impact of brief alcohol/ sexual risk reduction counseling with rapid HIV testing in the emergency department (ED).

We recruited 18-40 year olds with unhealthy alcohol use, sexual risk behaviors, and negative/unknown HIV status and assessed for differences in their alcohol consumption and sexual risk behaviors at baseline versus 2 months.

Participants (n = 85) were 61% male, mean age 26 years old, 59% white, 92% unmarried, 57% college educated, 45% without a regular doctor, and 80% with an Alcohol Use Disorders Identification Test (AUDIT) score ≥8. All rapid HIV tests were negative. Among the 70 (82%) with follow-up, alcohol consumption decreased with fewer average weekly drinks (23.6 vs. 9.8, p = .003) and binge drinking episodes (2.0 vs. .9, p = .012). Post-intervention, sexual risk decreased, including increased condom use (23% vs. 46%, p = .007). Women had a greater decrease in alcohol use prior to sex compared with men (p = .021 for interaction).

Alcohol/sexual risk reduction counseling with HIV testing in the ED is feasible and potentially effective for reducing alcohol use and sexual risk behaviors among young unhealthy drinkers.

Future randomized controlled trials are warranted to assess efficacy of this intervention, which would provide young at-risk populations with important preventive services, which they may not have access to otherwise.