Table 1.
The final research priority scores and ranks of the 50 research options after application of the CHNRI methodology to address the intersection of alcohol and HIV in low and middle income countries
| Importance or potential impact rank (overall rank) | Research options | Answerability | Effectiveness | Feasibility | Applicability | Equity | Overall RPS | Average expert agreement (AEA) |
|---|---|---|---|---|---|---|---|---|
| 1 | What is the link between alcohol use and adherence to HIV medication? | 99.1 | 90.4 | 98.2 | 91.4 | 93.4 | 94.5 | 0.92 |
| 2 | What is the effectiveness of health system-based intervention that involve training facility staff to foster an enabling environment for engagement of HIV-infected patients abusing alcohol? | 97.7 | 91.5 | 94.7 | 85.4 | 96 | 92.9 | 0.88 |
| 3 | What is prevalence and correlates of alcohol use among HIV+ pregnant women in Africa? | 98.7 | 91 | 94.9 | 82.8 | 94.3 | 92.3 | 0.89 |
| 4 | How does alcohol use in HIV+ pregnant and postpartum women impact retention in care and ART adherence? | 98.2 | 86.5 | 92.8 | 86.8 | 95 | 91.9 | 0.88 |
| 5 | What are the barriers to getting screening and brief interventions aimed at reducing hazardous and harmful alcohol use among persons on ARV treatment routinely carried out? | 94.6 | 88.9 | 95.5 | 87.6 | 92.6 | 91.8 | 0.88 |
| 6 | What is the effectiveness of motivational interviewing on antiretroviral therapy adherence, virological suppression, and alcohol consumption in HIV-infected adults? | 99.1 | 88.9 | 96.3 | 80.7 | 91.2 | 91.2 | 0.85 |
| 7 | What are the factors associated with alcohol use among HIV positive adolescents in LMIC? | 99.1 | 88.5 | 96.4 | 82.5 | 88 | 90.9 | 0.87 |
| 8 | Can alcohol reduction programmes be effectively integrated into HIV prevention, treatment and care programmes? | 97.7 | 89.1 | 91 | 87.7 | 88.5 | 90.8 | 0.87 |
| 9 | What are the barriers to adherence in ART users who abuse alcohol in LMICs? | 97.8 | 86.8 | 95 | 82.9 | 90.7 | 90.6 | 0.87 |
| 10 | What is the impact of alcohol exposure on ART effectiveness? | 94.8 | 91.3 | 89.8 | 85.7 | 90.7 | 90.5 | 0.84 |
| 11 | What are the clinical and cost effectiveness of integrating alcohol interventions into HIV care? | 96.2 | 86.5 | 93 | 83.8 | 90.8 | 90.1 | 0.85 |
| 12 | To what extent do reductions in drinking in people living with HIV contribute to improved health outcomes, including both HIV and non-HIV specific outcomes? | 93.3 | 85.8 | 89.6 | 83.2 | 93.3 | 89 | 0.85 |
| 13 | Is there any association of alcohol use with depression and HIV disease progression among people living with HIV/AIDS? | 96.5 | 86.3 | 93.1 | 79.6 | 89.6 | 89 | 0.84 |
| 14 | What is the prevalence of HIV among adolescents abusing alcohol? | 97.9 | 86 | 92.7 | 78.2 | 89.3 | 88.8 | 0.82 |
| 15 | How can we scale up the implementation of AUD treatment programmes integrated into HIV treatment programmes in LMIC? | 93.9 | 86.8 | 87.7 | 82.5 | 90.6 | 88.3 | 0.83 |
| 16 | Do mobile phone brief interventions reduce alcohol use and increase adherence amongst PLWHAs? | 96.4 | 86.1 | 90 | 81 | 85.3 | 87.8 | 0.82 |
| 17 | Would it be feasible to use visual aids or basic cell-phone apps to give information/reminders around drug regimen and timing or amount of alcohol use? | 95.5 | 84.5 | 88.5 | 80.7 | 85.8 | 87 | 0.82 |
| 18 | Does alcohol abuse decrease usage of HIV testing services? | 95.1 | 80.8 | 91.7 | 76.2 | 88.7 | 86.5 | 0.8 |
| 19 | What is the impact of alcohol exposure on HIV disease progression? | 90.9 | 84.3 | 87.7 | 79.7 | 89.1 | 86.3 | 0.79 |
| 20 | What is the optimal way to screen persons who are HIV+ for hazardous and harmful alcohol use? | 92.3 | 83.3 | 87.3 | 80.3 | 87.3 | 86.1 | 0.84 |
| 41 | What is the impact of low risk alcohol use on immunological outcomes in HIV positive individuals? | 92.1 | 65.5 | 84.2 | 71.3 | 76.1 | 77.8 | 0.72 |
| 42 | To what extent can technologies be used to increase the reach of behavioral interventions to reduce drinking? | 85.5 | 72.7 | 76.5 | 68.5 | 82.6 | 77.1 | 0.63 |
| 43 | Which interventions make drinking venues safer in terms of likelihood of unsafe sex amongst venue patrons? | 82 | 74.7 | 76.8 | 65.7 | 79.6 | 75.8 | 0.66 |
| 44 | How does alcohol use in pregnancy affect liver function among pregnant women on ART? | 84.6 | 70.8 | 74 | 64.1 | 79.2 | 74.5 | 0.6 |
| 45 | What is the relationship between cognitive performance and alcohol consumption in people with HIV? | 89 | 71 | 79.7 | 51 | 74.5 | 73.1 | 0.63 |
| 46 | Can mobile phone breathalyser applications be used to assess alcohol use among PLWHAs? | 90.8 | 68.6 | 73.5 | 56.5 | 68.9 | 71.7 | 0.59 |
| 47 | Can Disulfiram be used for the treatment of alcohol use disorders in PLWHA? | 82.2 | 66.7 | 76.7 | 63.1 | 68.6 | 71.5 | 0.58 |
| 48 | Is there a safe or low-risk level of alcohol use for persons with HIV on ART? | 74.3 | 67.7 | 71.1 | 67.2 | 73.4 | 70.7 | 0.59 |
| 49 | What is the cost-benefit of gains from alcohol promotion and marketing versus effects on sexual behaviour and ARVs treatment for people living with HIV or at risk of HIV infection? | 72.7 | 63.1 | 67.4 | 57.6 | 73.3 | 66.8 | 0.51 |
| 50 | What is the effect of excessive alcohol consumption by a senior family member on adherence and compliance to ART by HIV positive dependents in the family? | 78.2 | 58 | 69.7 | 55 | 72 | 66.6 | 0.55 |