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Dr. Patricia Molina, Professor and Chair of Physiology at LSU Health Sciences Center New Orleans, has been awarded a $2.7 million grant by the National Institutes of Health to develop a behavioral approach to reduce alcohol use and disorders in people living with HIV/AIDS. Alcohol use disorders are frequent in this population and are strongly associated with both decreased compliance in taking as well as the effectiveness of prescribed medicines. Alcohol is also linked to increased susceptibility to infection and viral replication.

A team of scientists led by Dr. Molina will work with LSUHSC physicians at the LSU HIV Outpatient Clinic as well as the LSUHSC School of Public Health. They will enroll 250 people living with HIV/AIDS in a clinical study that will compare intervention with a Holistic Health Recovery Program adapted for Alcohol Use Disorders with a control group in achieving or maintaining viral load suppression, reducing alcohol use and HIV risk behaviors, and improving anti-retroviral therapy adherence. It is hoped that this intervention and its future implementation will improve clinical outcomes by enhancing patients' awareness of the biomedical and psychosocial consequences of alcohol use in HIV/AIDS, and by enhancing the knowledge, motivation, and skills necessary to modify behaviors that promote HIV disease progression.

'This is the first study of this sort and it is important because the Louisiana HIV+ population appears to have a high level of alcohol use disorders compared nationally, and Louisiana also has a very high number of new HIV cases diagnosed per year,' notes Patricia Molina, MD, PhD, the Richard Ashman Professor of Physiology and Head of the Department of Physiology at LSU Health Sciences Center New Orleans and the grant's principal investigator.

Louisiana remains disproportionally affected by the HIV epidemic, with 18,602 people living with HIV/AIDS in 2011, 54% of whom had been diagnosed with AIDS, the 5th highest estimated state AIDS case rate. Among U.S. metropolitan areas, New Orleans ranks 9th in estimated HIV case rates (37 per 100,000) and 9th in AIDS case rates (23 per 100,000.)

LSU Health Sciences Center Comprehensive Alcohol Research Center researchers have demonstrated that chronic alcohol use elevates viral set point, increases lung viral levels during bacterial infection, promotes intestinal CD4+ and CD8+ T lymphocyte population changes that favor disease transmission, negatively affect bone metabolism, nitrogen balance, and skeletal muscle wasting, ultimately leading to accelerated disease progression to end-stage disease.
Efficacy of the intervention will lead to improved adherence to and effectiveness of ART, improved quality of life, and decreased risky behaviors that promote HIV transmission.

'Successfully decreasing the prevalence of alcohol use disorders in this vulnerable population has the potential to significantly and positively impact the HIV epidemic by decreasing the deleterious biomedical consequences of HIV infection, improving adherence to and effectiveness of anti-retroviral therapy, improving quality of life, and decreasing risky behaviors that promote HIV transmission,' concludes Dr. Molina.

The grant was awarded to LSU Health Sciences Center New Orleans by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health, and it is a five-year grant.

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