Feasibility Study for an Alcohol-Focused HIV Risk Reduction Program with the Sudan People's Liberation Army

Purpose: The purpose of this study was to evaluate the feasibility of a cognitive-behavioral therapy (CBT) risk reduction intervention focused on heavy drinking among the Sudan People’s Liberation Army (SPLA) in Juba, South Sudan.

Methods: The intervention included eight 60-minute sessions following the Matching Alcoholism Treatment to Client Heterogeneity (MATCH) CBT manual implemented over eight weeks. Topics included: Managing Thoughts about Alcohol; Problem Solving, Drink Refusal Skills, Awareness of Negative Thinking and Anger, Risk Reduction, and Enhancing Social Support Networks.  A guided 20-30 minute mindfulness meditation session was also included. Eligible participants were screened for inclusion and enrolled to form eight groups of 8 participants for a total of 64 SPLA members. Counselors trained in clinical skills and motivational interviewing were selected to deliver the intervention. Baseline and post-intervention follow-up assessments were conducted, including standard measures of alcohol use (AUDIT), potential depression (PHQ-2) and post-traumatic stress disorder (PC-PTSD).  

Results:From baseline to follow-up following the intervention, mean AUDIT scores were reduced from 17.6 to 0.9. The proportion screening positive for potential depression were reduced from 22.2% to 1.6% and for PTSD from 58.7% to 15.9%. In addition, the proportion reporting ≥ 2 sexual partners in the last 3 months reduced from 69.1% to 49.1%.

Conclusion/Recommendations: Alcohol use rates, and symptoms of depression and PTSD were all significantly reduced following the intervention. Further support to establish an alcohol-focused risk reduction program with improved clinical infrastructure in the SPLA is recommended.