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The Association Between Changes in Alcohol Use and Changes in Antiretroviral Therapy Adherence and Viral Suppression Among Women Living with HIV

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Abstract

Heavy alcohol use has adverse effects in women with HIV. We examined the association between changes in alcohol use (measured with Timeline Followback) and changes in antiretroviral therapy adherence (medication possession ratio) and viral suppression (HIV RNA), measured over 6-month intervals. Among women who were (1) non-adherent or not virologically suppressed and (2) infrequent binge drinkers or non-heavy drinkers at baseline, increasing drinking was significantly associated with lower odds of subsequently improving adherence or viral suppression (OR of becoming adherent of 0.90 in infrequent binge drinkers; OR of becoming suppressed of 0.81 and 0.75 in infrequent binge drinkers and non-heavy drinkers, respectively). Our findings suggest that for these women, increasing drinking may be a barrier to achieving viral suppression. Addressing this barrier by integrating proactive alcohol counseling strategies into routine HIV care may be key to improving viral suppression rates among women retained in HIV care.

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Funding

This study was funded by the National Institute of Alcohol Abuse and Alcoholism NIAAA R01 AA014500 (M.E.M., G.C., H.E.H.) and K23AA015313 (G.C.) and National Institute of Mental Health K23 MH 105284 02 (A.K.M).

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    Authors and Affiliations

    1. Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street #8060, Baltimore, MD, 21287, USA

      Nikita Barai, Anne Monroe, Anika Alvanzo & Geetanjali Chander

    2. Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA

      Anne Monroe, Catherine Lesko, Bryan Lau & Geetanjali Chander

    3. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA

      Heidi Hutton & Mary Elizabeth McCaul

    4. Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA

      Cui Yang

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    1. Nikita Barai
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    Correspondence to Anne Monroe.

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    Conflict of Interest

    Dr. Barai declares that she has no conflict of interest. Dr. Monroe declares that she has no conflict of interest. Dr. Lesko declares that she has no conflict of interest. Dr. Lau declares that he has no conflict of interest. Dr. Hutton declares that she has no conflict of interest. Dr. Yang declares that she has no conflict of interest. Dr. Alvanzo declares that she has no conflict of interest. Dr. McCaul declares that she has no conflict of interest. Dr. Chander declares that she has no conflict of interest.

    Ethical Approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

    Informed Consent

    Informed consent was obtained from all individual participants included in the study.

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    Drs Nikita Barai and Anne Monroe contributed equally to this article.

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    Barai, N., Monroe, A., Lesko, C. et al. The Association Between Changes in Alcohol Use and Changes in Antiretroviral Therapy Adherence and Viral Suppression Among Women Living with HIV. AIDS Behav 21, 1836–1845 (2017). https://doi.org/10.1007/s10461-016-1580-x

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    • DOI: https://doi.org/10.1007/s10461-016-1580-x

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