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CHART

Helping couples reduce unhealthy alcohol use and lower HIV risk through evidence-based behavioral interventions

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Mentorship
September 15, 2023

What is CHART?

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What is CHART?

CHART stands for Couples HIV and Alcohol Risk Reduction Trial. CHART is a research study designed to evaluate whether a combination of counseling and technology can reduce unhealthy drinking and lower HIV risk among couples

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Water Access
August 20, 2023

How does Chart Work ?

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How does Chart Work ?

CHART engages both partners in a couples-based approach. Participants work with a counselor through Couples Motivational Interviewing (CMI) and use biological feedback tools to track alcohol use. The study examines the feasibility, acceptability, and potential impact of combining these approaches to support alcohol reduction and HIV prevention.

Study Overview

Three Research Aims, One Shared Goal

CHART is designed to improve HIV prevention for couples by combining behavioral counseling with innovative technology. These three research aims guide the development, refinement, and evaluation of the intervention.

Develop Biological Feedback Tools for Alcohol and PrEP

This aim evaluates two biological feedback approaches: a mobile breathalyzer app that measures BAC (Blood Alcohol Content) daily and a PEth (Phosphatidyl ethanol) blood test, a biomarker that captures alcohol use over the previous 30 days. Researchers will interview 20 couples to assess acceptability, feasibility, and participant preferences for each approach.

Develop the Couples Counseling (CMI) Program

This aim adapts an existing 3-session Couples Motivational Interviewing (CMI) program to incorporate HIV prevention and PrEP (Pre-Exposure Prophylaxis). Researchers will gather input from couples and the CALIBER Community Advisory Board (CAB) to refine the intervention and ensure it is relevant, acceptable, and responsive to participant needs.

Test Everything Together

100 couples will be randomly assigned to one of four groups in an RCT (Randomized Controlled Trial): (1) CMI only, (2) biological feedback only (Blood Alcohol Content and PEth test results), (3) CMI + feedback combined, or (4) EUC (Enhanced Usual Care — standard support without the new intervention). Researchers will assess feasibility, participant satisfaction, alcohol use, PrEP uptake and adherence, and relationship quality over a six-month follow-up period to inform future efficacy testing.  

Findings from past research suggest that some participants viewed biological feedback as a tool that facilitated communication and accountability within their relationships. For example:
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"Sometimes I would show him how much he was drinking and advise him to distance himself from his friends, as being around them often leads to increased alcohol consumption."   — Study participant, Conroy et al., Addiction Science and Clinical Practice 2026
"She would tell me that I overdrank... it wasn't a big deal because it was disciplining me. She supported me a lot. Even when it came to taking a breathalyzer, I used to do it often because of her." — Study participant, Conroy et al., Addiction Science and Clinical Practice 2026

Eligibility

Age

Both partners are 18–64 years old

Relationship

In a primary relationship for at least 3 months

Alcohol Use

At least one partner meets unhealthy alcohol use criteria AUDIT-C ≥ 3 (women) AUDIT-C ≥ 4 (men)

Couples

Individuals participating with their partner

HIV Prevention

At least one partner is HIV-negative (other partner can be on PrEP)

Recent HIV Risk

Condomless sex with a casual partner, or HIV risk within the relationship during the past 30 days

Meet Our Research Leads

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Amy Conroy

Principal Investigator

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Tyrel Starks

Principal Investigator

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