Discussion
PWH, multiple co-morbidities
We compared two versions of a brief multi-session alcohol intervention targeted to PWH with unhealthy alcohol use adapted for the Ugandan context (We suspect that the self-reported decreases in alcohol use were at least in part due to social desirability, as SDS scores increased over the study period. In qualitative interviews conducted after the intervention (manuscript under review), participants reported feeling personally cared for by the study staff and counselors, motivated to reduce their alcohol use, and feeling shame when staff asked them whether they had reduced their drinking if they had not. The differences in results when measured by self-report versus PEth are consistent with discrepancies found in observational studies of PWH in Uganda (Prior trials of the efficacy of counselling-based alcohol interventions for PWH on alcohol use have shown either small or inconclusive intervention efficacy (The primary strengths of this study are that we measured PEth, and we had high follow-up rates. We were limited in our ability to study the impact of the interventions on viral suppression because viral non-suppression, which is low in Uganda (10 %) (In summary, while we found effects on self-reported alcohol use, we found no effects on PEth, indicating that neither version of this brief intervention was sufficient to substantially impact alcohol use. Because unhealthy alcohol use causes multiple co-morbidities to PWH (