Skip to main content

Number of Drinks to “Feel a Buzz” by HIV Status and Viral Load in Men


The impact of HIV and its treatment on the effects of alcohol remain unclear. Blood alcohol concentrations have been noted to be higher in HIV infected individuals prior to antiretroviral initiation. Our goal was to compare number of drinks to “feel a buzz or high” among HIV infected and uninfected men, stratified by viral load (VL) suppression. Data includes 1478 HIV infected and 1170 uninfected men in the veterans aging cohort study who endorsed current drinking. Mean (SD) number of drinks to feel a buzz was 3.1 (1.7) overall. In multivariable analyses, HIV infected men reported a lower mean number of drinks to feel a buzz compared to uninfected men (coef = −14 for VL < 500; −34 for VL ≥ 500; p ≤ .05). Men with HIV, especially those with a detectable VL, reported fewer drinks to feel a buzz. Future research on the relationship between alcohol and HIV should consider the role of VL suppression.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2



Veteran Aging Cohort Study


Antiretroviral therapy


HIV RNA viral load


Alcohol use disorder identification test-consumption


Heavy episodic drinking


International classification of diseases, ninth revision


Body mass index


Standard deviation



Alc Rel Dx:

Alcohol related ICD-9 diagnosis


  1. Saitz R. Clinical practice. Unhealthy alcohol use. N Engl J Med. 2005;352(6):596–607.

    Article  CAS  PubMed  Google Scholar 

  2. Justice AC, Lasky E, McGinnis KA, Skanderson M, Conigliaro J, Fultz SL, et al. Medical disease and alcohol use among veterans with human immunodeficiency infection: a comparison of disease measurement strategies. Med Care. 2006;44(8 Suppl 2):S52–60.

    Article  PubMed  Google Scholar 

  3. Braithwaite RS, Justice AC, Chang CC, Fusco JS, Raffanti SR, Wong JB, et al. Estimating the proportion of patients infected with HIV who will die of comorbid diseases. Am J Med. 2005;118(8):890–8.

    Article  PubMed  Google Scholar 

  4. Braithwaite RS, Conigliaro J, Roberts MS, Shechter S, Schaefer A, McGinnis K, et al. Estimating the impact of alcohol consumption on survival for HIV+ individuals. AIDS Care. 2007;19(4):459–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Samet JH, Horton NJ, Traphagen ET, Lyon SM, Freedberg KA. Alcohol consumption and HIV disease progression: are they related? Alcohol Clin Exp Res. 2003;27(5):862–7.

    Article  PubMed  Google Scholar 

  6. Samet JH, Horton NJ, Meli S, Freedberg KA, Palepu A. Alcohol consumption and antiretroviral adherence among HIV-infected persons with alcohol problems. Alcohol Clin Exp Res. 2004;28(4):572–7.

    Article  CAS  PubMed  Google Scholar 

  7. Braithwaite RS, McGinnis KA, Conigliaro J, Maisto SA, Crystal S, Day N, et al. A temporal and dose-response association between alcohol consumption and medication adherence among veterans in care. Alcohol Clin Exp Res. 2005;29(7):1190–7.

    Article  PubMed  Google Scholar 

  8. Lim JK, Tate JP, Fultz SL, Goulet JL, Conigliaro J, Bryant KJ, et al. Relationship between alcohol use categories and noninvasive markers of advanced hepatic fibrosis in HIV-infected, chronic hepatitis C virus-infected, and uninfected patients. Clin Infect Dis. 2014;58(10):1449–58.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Cook RL, McGinnis KA, Kraemer KL, Gordon AJ, Conigliaro J, Maisto SA, et al. Intoxication before intercourse and risky sexual behavior in male veterans with and without human immunodeficiency virus infection. Med Care. 2006;44(8 Suppl 2):S31–6.

    Article  PubMed  Google Scholar 

  10. McCance-Katz EF, Lum PJ, Beatty G, Gruber VA, Peters M, Rainey PM. Untreated HIV infection is associated with higher blood alcohol levels. J Acquir Immune Defic Syndr. 2012;60(3):282–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. McCance-Katz EF, Gruber VA, Beatty G, Lum PJ, Rainey PM. Interactions between alcohol and the antiretroviral medications ritonavir or efavirenz. J Addict Med. 2013;7(4):264–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Midanik LT. Drunkenness, feeling the effects and 5+ measures. Addiction. 1999;94(6):887–97.

    Article  CAS  PubMed  Google Scholar 

  13. Levitt A, Sher KJ, Bartholow BD. The language of intoxication: preliminary investigations. Alcohol Clin Exp Res. 2009;33(3):448–54.

    Article  PubMed  Google Scholar 

  14. Weathermon R, Crabb DW. Alcohol and medication interactions. Alcohol Res Health. 1999;23(1):40–54.

    CAS  PubMed  Google Scholar 

  15. Justice AC, Dombrowski E, Conigliaro J, Fultz SL, Gibson D, Madenwald T, et al. Veterans aging cohort study (VACS): overview and description. Med Care. 2006;44(8 Suppl 2):S13–24.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Conigliaro J, Madenwald T, Bryant K, Braithwaite S, Gordon A, Fultz SL, et al. The Veterans Aging Cohort Study: observational studies of alcohol use, abuse, and outcomes among human immunodeficiency virus-infected veterans. Alcohol Clin Exp Res. 2004;28(2):313–21.

    Article  PubMed  Google Scholar 

  17. Greenfield TK, Midanik LT, Rogers JD. A 10-year national trend study of alcohol consumption, 1984–1995: is the period of declining drinking over? Am J Public Health. 2000;90(1):47–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Midanik LT. Definitions of drunkenness. Subst Use Misuse. 2003;38(9):1285–303.

    Article  PubMed  Google Scholar 

  19. Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory care quality improvement project (ACQUIP). Alcohol use disorders identification test. Arch Intern Med. 1998;158(16):1789–95.

    Article  CAS  PubMed  Google Scholar 

  20. McGinnis KA, Justice AC, Kraemer KL, Saitz R, Bryant KJ, Fiellin DA. Comparing alcohol screening measures among HIV-infected and -uninfected men. Alcohol Clin Exp Res. 2013;37(3):435–42.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Justice AC, McGinnis KA, Skanderson M, Chang CC, Gibert CL, Goetz MB, et al. Towards a combined prognostic index for survival in HIV infection: the role of ‘non-HIV’ biomarkers. HIV Med. 2010;11(2):143–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Tate JP, Justice AC, Hughes MD, Bonnet F, Reiss P, Mocroft A, et al. An internationally generalizable risk index for mortality after one year of antiretroviral therapy. AIDS. 2013;27(4):563–72.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Justice AC, Freiberg MS, Tracy R, Kuller L, Tate JP, Goetz MB, et al. Does an index composed of clinical data reflect effects of inflammation, coagulation, and monocyte activation on mortality among those aging with HIV? Clin Infect Dis. 2012;54(7):984–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Wagner JH, Justice AC, Chesney M, Sinclair G, Weissman S, Rodriguez-Barradas M. Patient- and provider-reported adherence: toward a clinically useful approach to measuring antiretroviral adherence. J Clin Epidemiol. 2001;54(Suppl 1):S91–8.

    Article  PubMed  Google Scholar 

  25. Butt AA, McGinnis K, Rodriguez-Barradas MC, Crystal S, Simberkoff M, Goetz MB, et al. HIV infection and the risk of diabetes mellitus. AIDS. 2009;23(10):1227–34.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Maudens KE, Patteet L, van Nuijs AL, Van BC, Covaci A, Neels H. The influence of the body mass index (BMI) on the volume of distribution of ethanol. Forensic Sci Int. 2014;243C:74–8.

    Article  Google Scholar 

  27. William G. Linear splines and piecewise linear functions. Stata Technical Bulletin 15. Stata Technical Bulletin Reprints. 3. College Station, TX: Stata Corporation; 1993. p. 13–7.

  28. StataCorp. Stata Statistical Software: release 13.0. College Station: Stata Corporation; 2013.

  29. Assimakopoulos SF, Dimitropoulou D, Marangos M, Gogos CA. Intestinal barrier dysfunction in HIV infection: pathophysiology, clinical implications and potential therapies. Infection. 2014;42:951–9.

    Article  CAS  PubMed  Google Scholar 

  30. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, an statistical considerations. J Pers Soc Psychol. 1986;51(6):1173–82.

    Article  CAS  PubMed  Google Scholar 

  31. Me S. Asymptotic confidence intervals for indirect effects in structural equation models. Sociol Methodol. 1982;13:290–312.

    Article  Google Scholar 

  32. Me S. Some new results on indirect effects and their standard errors in covariance structure models. Sociol Methodol. 1986;16:159–86.

    Article  Google Scholar 

  33. Hesselbrock M, Babor TF, Hesselbrock V, Meyer RE, Workman K. “Never believe an alcoholic”? On the validity of self-report measures of alcohol dependence and related constructs. Subst Use Misuse. 1983;18(5):593–609.

    CAS  Google Scholar 

  34. Del Boca FK, Darkes J. The validity of self-reports of alcohol consumption: state of the science and challenges for research. Addiction. 2003;98(Suppl 2):1–12.

    Article  PubMed  Google Scholar 

  35. Litten RZ, Fertig J. Self-report and biochemical measures of alcohol consumption. Addiction. 2003;98(Suppl 2):3–4.

    Article  Google Scholar 

  36. Litten RZ, Bradley AM, Moss HB. Alcohol biomarkers in applied settings: recent advances and future research opportunities. Alcohol Clin Exp Res. 2010;34(6):955–67.

    Article  CAS  PubMed  Google Scholar 

  37. Kerr WC, Greenfield TK, Midanik LT. How many drinks does it take you to feel drunk? Trends and predictors for subjective drunkenness. Addiction. 2006;101(10):1428–37.

    Article  PubMed  Google Scholar 

Download references


The views are not those of the Department of Veterans Affairs or the United States Government. COMpAAAS/Veterans Aging Cohort Study, a CHAART Cooperative Agreement, is supported by the National Institutes of Health: National Institute on Alcohol Abuse and Alcoholism (U24-AA020794, U01-AA020790, U01-AA020795, U01-AA020799; U10 AA013566-completed) and in kind by the US Department of Veterans Affairs.

Author information

Authors and Affiliations



Corresponding author

Correspondence to Kathleen A. McGinnis.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

McGinnis, K.A., Fiellin, D.A., Tate, J.P. et al. Number of Drinks to “Feel a Buzz” by HIV Status and Viral Load in Men. AIDS Behav 20, 504–511 (2016).

Download citation

  • Published:

  • Issue Date:

  • DOI:


  • HIV
  • Alcohol intoxication
  • Alcohol use
  • Alcohol-related disorders
  • Buzz