ENGLISH :
Aims. To test motivational interviewing (MI) as a brief intervention for reducing alcohol use among needle exchange clients. Design. Randomized clinical trial. Setting. Needle exchange program-Providence, Rhode Island, USA. Participants. Between 2/98 and 10/99, we recruited 1 87 AUDIT-positive (>8) active injection drug users. Intervention.Those assigned to a brief motivational intervention (MI) condition received two 1-hour therapist sessions following assessment visits, 1 month apart, focusing on alcohol use and HIV risk-taking. Measurements. Control and MI subjects received identical research assessments at baseline, 1 and 6 months following study enrollment. At 6 months, study outcomes included days of alcohol use measured using the time-line follow-back method. Findings. Study retention was 96.8%, at 6 months. Participants reported an average of 12.0 drinking days at baseline and 8.3 at 6 months. Significant reductions in drinking days were observed in both treatment conditions. We found significant treatment x baseline drinking day interaction effects.Tests for simple main effects were significant for subjects with above median (>9) baseline drinking day frequency, but not for those with below median baseline drinking frequency. Comparisons on dichotomous outcomes provided supporting evidence of treatment efficacy; those in MI were over two times more likely than controls to report reductions of 7 days or more (P