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Description:HHRP-A is a group-level intervention designed to improve viral load, ART adherence, and service utilization among people with HIV who have a history of alcohol abuse. The intervention is adapted from the Holistic Health Recovery Program (HHRP), a group-level risk-reduction intervention for people with HIV who inject drugs. The intervention includes eight 2-hour group sessions that are scheduled 1 to 2 times per week over consecutive weeks. The sessions are delivered using didactic presentation of materials and experiential exercises. Groups include 8 participants of the same gender and promote interaction between participants to enable the building of positive social support networks among peers. Intervention sessions focus on the following skills: decision-making and problemsolving skills using cognitive remediation strategies; goalsetting; stress management; health improvement, healthcare participation, and adherence to medical treatments; harm reduction through personal spirituality; and self-efficacy. The intervention also addresses relapse prevention; improving emotional, social, and spiritual health; coping with stigma and grief; and reducing HIV sexual transmission risk behavior. Additionally, alcohol use is addressed by exploring decisions that lead to relapse and other unhealthy behaviors, as well as through an in-depth discussion of the principles of the 12 steps of Alcoholics Anonymous, concepts of powerlessness/control, finding inner sources of strength, and social relationships that contribute to paths of sobriety versus relapse. Cognitive remediation strategies, including behavioral games and memory books, are incorporated in the intervention because of the potential for neurocognitive impairment in this population.
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