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The SEAL Study investigates the complex interactions between pre-exposure prophylaxis (PrEP) use, alcohol consumption, and gut microbiome health. Our goal is to better understand how these factors influence each other to improve health outcomes. Specifically, we hope to better understand how alcohol use impacts PrEP adherence and health outcomes, with a particular focus on the gut microbiome, an under researched factor in HIV prevention.
While PrEP is a highly effective medication regimen to prevent HIV it is underutilized. Also, many PrEP users report frequent alcohol use, which may impact PrEP adherence. It may also worsen PrEP-related gastrointestinal (GI) side effects, disrupt gut health, and ultimately affect a person’s ability to stay on PrEP consistently. Despite these concerns, little is known about how people make decisions around PrEP and alcohol use, or how interventions might help.
The SBIRT Model
Screening: Screening is a process of identifying patients with possible substance misuse or abuse problems and determining the appropriate course of future action for these individuals.
Brief Intervention: Brief intervention (BI) is appropriate for patients identified through screening to be at moderate risk for substance use problems.
Referral to Treatment: Patients identified as needing more intensive treatment are referred for specialty SUD treatment. The primary goals of referral to treatment (RT) are to identify an appropriate treatment program and to facilitate engagement of the patient in treatment.
Through a randomized controlled trial, we are working with PrEP users in Louisville, KY, to assess the effectiveness of SBIRT (Screening, Brief Intervention, and Referral to Treatment) in reducing alcohol use among PrEP users who drink at hazardous levels. We will also examine how SBIRT impacts PrEP adherence, decision-making, and gut health over time, compared to standard care and PrEP users who do not demonstrate elevated alcohol use.
Our study combines quantitative measures and qualitative interviews to better understand the lived experiences of PrEP users and the factors that shape their healthcare decisions. By focusing on this intersection of alcohol use, gut health, and PrEP, we aim to support priority populations who face barriers to staying engaged in HIV prevention.
If you'd like to learn more about the aims of our study, click the above button.
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