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Changes in Days of Unhealthy Alcohol Use and Antiretroviral Therapy Adherence, HIV RNA Levels, and Condomless Sex: A Secondary Analysis of Clinical Trial Data

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Abstract

In a sample of people with HIV (PWH) enrolled in an alcohol intervention trial and followed for 12 months, we examined the association of changes in days (i.e., decrease, increase, no change [reference]) of unhealthy drinking (consuming ≥ 4/≥ 5 drinks for women/men) with antiretroviral therapy adherence (≥ 95% adherent), viral suppression (HIV RNA < 75 copies/mL), condomless sex with HIV-negative/unknown status partners, and dual-risk outcome (HIV RNA ≥ 75 copies/mL plus condomless sex). The sample included 566 PWH (96.8% male; 63.1% White; 93.9% HIV RNA < 75 copies/mL) who completed baseline, 6-, and 12-month assessments. Decrease in days of unhealthy drinking was associated with increased likelihood of viral suppression (odds ratio [OR] 3.78; 95% confidence interval [CI] 1.06, 13.51, P = .04) versus no change. Increase in days of unhealthy drinking was associated with increased likelihood of condomless sex (OR 3.13; 95% CI 1.60, 6.12, P < .001). Neither increase nor decrease were associated with adherence or dual-risk outcome. On a continuous scale, for each increase by 1 day of unhealthy drinking in the prior month, the odds of being 95% adherent decreased by 6% (OR 0.94, 95% CI 0.88, 1.00, P = 0.04).

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Acknowledgements

We thank Agatha Hinman for assistance in preparing the manuscript.

Funding

National Institute on Alcohol Abuse and Alcoholism, U01 AA021997, K24 AA025703.

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Authors and Affiliations

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

    Derek D. Satre, Varada Sarovar, Wendy Leyden, J. Carlo Hojilla & Michael J. Silverberg

  2. Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA

    Derek D. Satre & J. Carlo Hojilla

  3. Department of Adult and Family Medicine, Kaiser Permanente San Francisco Medical Center, San Francisco, CA, USA

    Charles B. Hare

  4. Betty Irene Moore School of Nursing, University of California at Davis, Sacramento, CA, USA

    Sheryl L. Catz

  5. National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA

    Kendall J. Bryant

  6. Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound, Seattle, WA, USA

    Emily C. Williams

  7. Department of Health Services, University of Washington, Seattle, WA, USA

    Emily C. Williams

  8. Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, MD, USA

    Michael A. Horberg

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  1. Derek D. Satre
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Satre, D.D., Sarovar, V., Leyden, W. et al. Changes in Days of Unhealthy Alcohol Use and Antiretroviral Therapy Adherence, HIV RNA Levels, and Condomless Sex: A Secondary Analysis of Clinical Trial Data. AIDS Behav 24, 1784–1792 (2020). https://doi.org/10.1007/s10461-019-02742-y

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