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Factors Associated with Bothersome Symptoms in Individuals With and Without HIV Who Report Alcohol Use

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Abstract

Bothersome symptoms potentially related to drinking are commonly reported by people with and without HIV (PWH/PWoH). However, the relationship between bothersome symptoms and level of alcohol use is often not appreciated by patients or providers. Therefore, among persons reporting prior-year alcohol use, we assessed whether alcohol use level (AUDIT-C score), HIV status, and demographic covariates influenced the likelihood of the patient reporting a bothersome symptom. We used the Veterans Aging Cohort Study (VACS) surveys (2002–2018), including a validated symptoms index. Among 3679 PWH and 3830 PWoH currently drinking alcohol, the most commonly reported symptoms were muscle/joint pain (52%), sleep disturbance (51%), and fatigue (50%). Level of alcohol use was independently associated with 18 of 20 bothersome symptoms, including seven symptoms more common among PWH. Results can help inform PWH/PWoH who drink alcohol about the strong relationship between level of alcohol use and bothersome symptoms, potentially motivating reduced use.

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Data Availability

Data requests should be submitted by email to the corresponding author; data will be available pending VACS approval.

References

  1. Boyer V, Vilotitch A, Marcellin F, et al. Self-reported bothersome symptoms across different socioepidemiological groups of people living with HIV attending French hospitals: results from the ANRS-VESPA2 survey. J Pain Symptom Manage. 2017;54(1):110–9.

    Article  PubMed  Google Scholar 

  2. Wing EJ. HIV and aging. Int J Infect Dis. 2016;53:61–8.

    Article  PubMed  Google Scholar 

  3. Nkhoma K, Ahmed A, Alli Z, Sherr L, Harding R. Is symptom prevalence and burden associated with HIV treatment status and disease stage among adult HIV outpatients in Kenya? A cross-sectional self-report study. AIDS Care. 2019;31(12):1461–70.

    Article  PubMed  Google Scholar 

  4. Wilson NL, Azuero A, Vance DE, et al. Identifying symptom patterns in people living with HIV disease. J Assoc Nurses AIDS Care. 2016;27(2):121–32.

    Article  PubMed  Google Scholar 

  5. Edelman EJ, Maisto SA, Hansen NB, et al. Integrated stepped alcohol treatment for patients with HIV and at-risk alcohol use: a randomized trial. Addict Sci Clin Pract. 2020;15(1):28.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Duko B, Ayalew M, Ayano G. The prevalence of alcohol use disorders among people living with HIV/AIDS: a systematic review and meta-analysis. Subst Abuse Treat Prev Policy. 2019;14(1):52.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Krupitsky EM, Horton NJ, Williams EC, et al. Alcohol use and HIV risk behaviors among HIV-infected hospitalized patients in St. Petersburg, Russia. Drug Alcohol Depend. 2005;79(2):251–6.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Nguyen MX, McNaughton Reyes HL, Pence BW, et al. The longitudinal association between depression, anxiety symptoms and HIV outcomes, and the modifying effect of alcohol dependence among ART clients with hazardous alcohol use in Vietnam. J Int AIDS Soc. 2021;24(S2): e25746.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Cahill S, Valadéz R. Growing older with HIV/AIDS: new public health challenges. Am J Public Health. 2013;103(3):e7-15.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Moitra E, Anderson BJ, Herman DS, et al. Examination of using alcohol to cope, depressive symptoms, and perceived social support in persons with HIV and Hepatitis C. AIDS Care. 2020;32(10):1238–45.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Sullivan LE, Goulet JL, Justice AC, Fiellin DA. Alcohol consumption and depressive symptoms over time: a longitudinal study of patients with and without HIV infection. Drug Alcohol Depend. 2011;117(2):158–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Williams EC, McGinnis KA, Edelman EJ, et al. Level of alcohol use associated with HIV care continuum targets in a national US sample of persons living with HIV receiving healthcare. AIDS Behav. 2019;23(1):140–51.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Williams EC, Hahn JA, Saitz R, Bryant K, Lira MC, Samet JH. Alcohol use and human immunodeficiency virus (HIV) infection: current knowledge, implications, and future directions. Alcohol Clin Exp Res. 2016;40(10):2056–72.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Justice AC, McGinnis KA, Tate JP, et al. Risk of mortality and physiologic injury evident with lower alcohol exposure among HIV infected compared with uninfected men. Drug Alcohol Depend. 2016;161:95–103.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Matson TE, McGinnis KA, Rubinsky AD, et al. Gender and alcohol use: influences on HIV care continuum in a national cohort of patients with HIV. AIDS Lond Engl. 2018;32(15):2247–53.

    Article  Google Scholar 

  16. Williams EC, Lapham GT, Shortreed SM, et al. Among patients with unhealthy alcohol use, those with HIV are less likely than those without to receive evidence-based alcohol-related care: a national VA study. Drug Alcohol Depend. 2017;174:113–20.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Williams EC, McGinnis KA, Bobb JF, et al. Changes in alcohol use associated with changes in HIV disease severity over time: a national longitudinal study in the Veterans Aging Cohort. Drug Alcohol Depend. 2018;189:21–9.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Williams EC, McGinnis KA, Tate JP, et al. HIV disease severity is sensitive to temporal changes in alcohol use: a national study of VA patients with HIV. J Acquir Immune Defic Syndr. 2019;81(4):448–55.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Williams EC, Joo YS, Lipira L, Glass JE. Psychosocial stressors and alcohol use, severity, and treatment receipt across human immunodeficiency virus (HIV) status in a nationally representative sample of US residents. Subst Abuse. 2017;38(3):269–77.

    Article  Google Scholar 

  20. Gordon KS, Becker WC, Bryant KJ, et al. Patient-reported bothersome symptoms attributed to alcohol use among people with and without HIV. AIDS Behav. 2022;26(11):3589–96. https://doi.org/10.1007/s10461-022-03628-2.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Mathews WC, McCutchan JA, Asch S, et al. National estimates of HIV-related symptom prevalence from the HIV cost and services utilization study. Med Care. 2000;38(7):750–62.

    Article  CAS  PubMed  Google Scholar 

  22. Webel AR, Wantland D, Rose CD, et al. A cross-sectional relationship between social capital, self-compassion, and perceived HIV symptoms. J Pain Symptom Manag. 2015;50(1):59–68.

    Article  Google Scholar 

  23. Satre D, Sarovar V, Leyden W, et al. Age group differences in two-year outcomes, substance use and health services among people with HIV enrolled in a primary-care based alcohol treatment study. Aging Ment Health. 2022. https://doi.org/10.1080/13607863.2022.2084504.

    Article  PubMed  Google Scholar 

  24. Edelman EJ, Gordon K, Justice AC. Patient and provider-reported symptoms in the post-cART era. AIDS Behav. 2011;15(4):853–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Edelman EJ, Gordon K, Rodriguez-Barradas MC, Justice AC, Vacs Project Team. Patient-reported symptoms on the antiretroviral regimen efavirenz/emtricitabine/tenofovir. AIDS Patient Care STDs. 2012;26(6):312–9.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Justice AC, Holmes W, Gifford AL, et al. Development and validation of a self-completed HIV symptom index. J Clin Epidemiol. 2001;54(12):S77-90.

    Article  PubMed  Google Scholar 

  27. Justice AC, Dombrowski E, Conigliaro J, 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 

  28. Justice AC, Chang CH, Rabeneck L, Zackin R. Clinical importance of provider-reported HIV symptoms compared with patient-report. Med Care. 2001;39(4):397–408.

    Article  CAS  PubMed  Google Scholar 

  29. 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 

  30. Bradley KA, Bush KR, Epler AJ, et al. Two brief alcohol-screening tests from the Alcohol Use Disorders Identification Test (AUDIT): validation in a female Veterans Affairs patient population. Arch Intern Med. 2003;163(7):821–9.

    Article  PubMed  Google Scholar 

  31. Bradley KA, DeBenedetti AF, Volk RJ, Williams EC, Frank D, Kivlahan DR. AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res. 2007;31(7):1208–17.

    Article  PubMed  Google Scholar 

  32. McGinnis KA, Tate JP, Williams EC, et al. Comparison of AUDIT-C collected via electronic medical record and self-administered research survey in HIV infected and uninfected patients. Drug Alcohol Depend. 2016;168:196–202.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Rubinsky AD, Dawson DA, Williams EC, Kivlahan DR, Bradley KA. AUDIT-C scores as a scaled marker of mean daily drinking, alcohol use disorder severity, and probability of alcohol dependence in a U.S. general population sample of drinkers. Alcohol Clin Exp Res. 2013;37(8):1380–90.

    Article  PubMed  Google Scholar 

  34. Macallan DC. Wasting in HIV infection and AIDS. J Nutr. 1999;129(1):238S-242S.

    Article  CAS  PubMed  Google Scholar 

  35. Wanke CA, Silva M, Knox TA, Forrester J, Speigelman D, Gorbach SL. Weight loss and wasting remain common complications in individuals infected with human immunodeficiency virus in the era of highly active antiretroviral therapy. Clin Infect Dis. 2000;31(3):803–5.

    Article  CAS  PubMed  Google Scholar 

  36. Mangili A, Murman DH, Zampini AM, Wanke CA. Nutrition and HIV infection: review of weight loss and wasting in the era of highly active antiretroviral therapy from the nutrition for healthy living cohort. Clin Infect Dis. 2006;42(6):836–42.

    Article  CAS  PubMed  Google Scholar 

  37. Hicks CW, Selvin E. Epidemiology of peripheral neuropathy and lower extremity disease in diabetes. Curr Diab Rep. 2019;19(10):86.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Noubissi EC, Katte J-C, Sobngwi E. Diabetes and HIV. Curr Diab Rep. 2018;18(11):125.

    Article  PubMed  Google Scholar 

  39. Duncan R, Francis RM, Collerton J, et al. Prevalence of arthritis and joint pain in the oldest old: findings from the Newcastle 85+ Study. Age Ageing. 2011;40(6):752–5.

    Article  PubMed  Google Scholar 

  40. Molina PE, Simon L, Amedee AM, Welsh DA, Ferguson TF. Impact of alcohol on HIV disease pathogenesis, comorbidities and aging: integrating preclinical and clinical findings. Alcohol Alcohol. 2018;53(4):439–47.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. 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 

  42. Samet JH, Cheng DM, Libman H, Nunes DP, Alperen JK, Saitz R. Alcohol consumption and HIV disease progression. J Acquir Immune Defic Syndr. 2007;46(2):194–9.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Baum MK, Rafie C, Lai S, Sales S, Page JB, Campa A. Alcohol use accelerates HIV disease progression. AIDS Res Hum Retrovir. 2010;26(5):511–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Chander G, Lau B, Moore RD. Hazardous alcohol use: a risk factor for non-adherence and lack of suppression in HIV infection. J Acquir Immune Defic Syndr. 2006;43(4):411–7.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Braithwaite RS, McGinnis KA, Conigliaro J, 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 

  46. Schnall R, Siegel K, Jia H, Olender S, Hirshfield S. Racial and socioeconomic disparities in the symptom profile of persons living with HIV. AIDS Care. 2018;30(6):774–83.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Evangelidou S, NeMoyer A, Cruz-Gonzalez M, O’Malley I, Alegría M. Racial/ethnic differences in general physical symptoms and medically unexplained physical symptoms: investigating the role of education. Cult Divers Ethn Minor Psychol. 2020;26(4):557–69.

    Article  Google Scholar 

  48. General (US) O of the S, Services (US) C for MH, Health (US) NI of M. Chapter 2 culture counts: the influence of culture and society on mental health. Substance Abuse and Mental Health Services Administration (US); 2001 [cited 2022 Jun 30]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK44249/.

  49. Shepherd SM, Willis-Esqueda C, Paradies Y, Sivasubramaniam D, Sherwood J, Brockie T. Racial and cultural minority experiences and perceptions of health care provision in a mid-western region. Int J Equity Health. 2018;17(1):33.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors of this report would like to thank the VACS participants for their contributions to this research.

Funding

Our study is funded by the National Institutes of Health and the National Institute on Alcohol Abuse and Alcoholism (Grant Nos. U24-AA020794, U01-AA020790, U10-A013566-completed, U01-AA020795, U01-AA020799, U24-AA022001, and U24-AA022007).

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Authors and Affiliations

  1. Department of Psychiatry, University of Calgary, Calgary, AB, Canada

    Anees Bahji

  2. Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada

    Anees Bahji

  3. Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada

    Anees Bahji

  4. British Columbia Centre on Substance Use, Vancouver, BC, Canada

    Anees Bahji

  5. Research in Addiction Medicine Scholars Program, Boston University Medical Centre, Boston, MA, USA

    Anees Bahji

  6. VA Connecticut Healthcare System, West Haven, CT, USA

    Kirsha S. Gordon & Amy C. Justice

  7. Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA

    Kirsha S. Gordon, E. Jennifer Edelman & Amy C. Justice

  8. Center for Health Services Research, Rutgers University, New Brunswick, NJ, USA

    Stephen Crystal

  9. Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA

    Derek D. Satre

  10. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA

    Derek D. Satre

  11. Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA

    Emily C. Wiliams

  12. Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, USA

    E. Jennifer Edelman

  13. Yale School of Public Health, New Haven, CT, USA

    Amy C. Justice

  14. Yale School of Medicine, 367 Cedar Street, ESH A, suite 401, New Haven, CT, 06510, USA

    E. Jennifer Edelman

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  1. Anees Bahji
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Correspondence to E. Jennifer Edelman.

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Bahji, A., Gordon, K.S., Crystal, S. et al. Factors Associated with Bothersome Symptoms in Individuals With and Without HIV Who Report Alcohol Use. AIDS Behav 27, 2455–2462 (2023). https://doi.org/10.1007/s10461-022-03972-3

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