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Prevalence and Factors Associated with Hazardous Alcohol Use Among Persons Living with HIV Across the US in the Current Era of Antiretroviral Treatment

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Abstract

Hazardous alcohol use is associated with detrimental health outcomes among persons living with HIV (PLWH). We examined the prevalence and factors associated with hazardous alcohol use in the current era using several hazardous drinking definitions and binge drinking defined as ≥5 drinks for men versus ≥4 for women. We included 8567 PLWH from 7 U.S. sites from 2013 to 2015. Current hazardous alcohol use was reported by 27% and 34% reported binge drinking. In adjusted analyses, current and past cocaine/crack (odd ratio [OR] 4.1:3.3–5.1, p < 0.001 and OR 1.3:1.1–1.5, p < 0.001 respectively), marijuana (OR 2.5:2.2–2.9, p < 0.001 and OR 1.4:1.2–1.6, p < 0.001), and cigarette use (OR 1.4:1.2–1.6, p < 0.001 and OR 1.3:1.2–1.5, p < 0.001) were associated with increased hazardous alcohol use. The prevalence of hazardous alcohol use remains high in the current era, particularly among younger men. Routine screening and targeted interventions for hazardous alcohol use, potentially bundled with interventions for other drugs, remain a key aspect of HIV care.

Resumen

El consumo riesgoso de alcohol se asocia a los resultados adversos de salud entre las personas que viven con VIH (PLWH, por sus siglas en inglés). Estudiamos la preponderancia y los factores asociados al consumo riesgoso en la época actual con el uso de distintas definiciones de beber alcohol en forma riesgosa y consumir alcohol en forma desmedida, que se define como el consumo de ≥ 5 tragos para hombres y ≥ 4 tragos para mujeres. Incluimos a 8567 PLWH de 7 lugares distintos de EE. UU entre 2013 y 2015. El 27% informó de consumo de alcohol en forma riesgosa y el 34% informó de consumo de alcohol en forma desmedida en la actualidad. En el análisis ajustado, el consumo actual y pasado de cocaína o crack (índice de probabilidad [OR, por sus siglas en inglés] 4,1:3,3-5,1, p < 0,001 y OR 1,3:1,1-1,5, p < 0,001, respectivamente), marihuana (OR 2,5:2,2-2,9, p < 0,001 y OR 1,4:1,2-1,6, p < 0,001) y consumo de cigarrillo (OR 1,4:1,2-1,6, p < 0,001 y OR 1,3:1,2-1,5, p < 0,001) se asoció al consumo de alcohol cada vez más riesgoso. La prevalencia del consumo de alcohol en forma riesgosa permanece alta en la actualidad, en especial entre los hombres más jóvenes. Los análisis de rutina y las intervenciones dirigidas a públicos específicos para abordar el consumo riesgoso de alcohol, posiblemente en conjunto con intervenciones para abordar el consumo de otras drogas, sigue siendo un aspecto clave del tratamiento contra el VIH.

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Acknowledgements

We thank the patients and providers throughout the CNICS network. This work was supported by the National Institutes of Alcohol Abuse and Alcoholism (NIAAA) at the National Institutes of Health [U24AA020801, U01AA020793 and U01AA020802]. Additional support came from the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health [CNICS R24 AI067039, UW CFAR NIAID Grant P30 AI027757, UNC CFAR Grant P30 AI50410, and UAB CFAR Grant P30 AI027767].

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Authors and Affiliations

  1. Department of Medicine, University of Washington, 325 9th Ave Box 359931, Seattle, WA, USA

    Heidi M. Crane, Robin M. Nance, Joseph O. Merrill, Daniel R. Drozd, Rob J. Fredericksen & Mari M. Kitahata

  2. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA

    Mary E. McCaul & Heidi Hutton

  3. Department of Medicine, Johns Hopkins University, Baltimore, MD, USA

    Geetanjali Chander & Richard D. Moore

  4. Department of Epidemiology, University of Washington, Seattle, WA, USA

    Joseph A. C. Delaney

  5. Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA

    Bryan Lau

  6. Fenway Institute and Department of Medicine, Harvard Medical School, Boston, MA, USA

    Kenneth H. Mayer

  7. Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Michael J. Mugavero, James H. Willig, Greer A. Burkholder & Michael S. Saag

  8. Fenway Institute and Division of Psychiatry, Harvard Medical School, Boston, MA, USA

    Matthew Mimiaga

  9. Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL, USA

    Karen Cropsey

  10. Department of Psychology, University of Washington, Seattle, WA, USA

    Jane M. Simoni

  11. Department of Medicine, University of California at San Diego, San Diego, CA, USA

    W. Christopher Mathews

  12. Department of Medicine, University of North Carolina, Chapel Hill, NC, USA

    Joseph J. Eron & Sonia Napravnik

  13. Department of Medicine, University of California at San Francisco, San Francisco, CA, USA

    Katerina Christopoulos & Elvin Geng

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  1. Heidi M. Crane
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  2. Mary E. McCaul
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  24. Michael S. Saag
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  25. Mari M. Kitahata
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Correspondence to Heidi M. Crane.

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All sites have approval from Human Subjects committees at their local institution and participants signed informed consent to participate in CNICS. All data submitted to the CNICS Data Repository are deidentified. For this retrospective data analysis of existing deidentified data in the CNICS Data Repository, no additional formal consent is required.

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This article does not contain any studies with animals performed by any of the authors.

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Crane, H.M., McCaul, M.E., Chander, G. et al. Prevalence and Factors Associated with Hazardous Alcohol Use Among Persons Living with HIV Across the US in the Current Era of Antiretroviral Treatment. AIDS Behav 21, 1914–1925 (2017). https://doi.org/10.1007/s10461-017-1740-7

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