Changing Patterns of Alcohol Use and Probability of Unsuppressed Viral Load Among Treated Patients with HIV Engaged in Routine Care in the United States

Overview

Journal AIDS Behav

Specialty Infectious Diseases

Date 2020 Oct 16

PMID 33064249

Citations 8

Authors

Catherine R Lesko

Robin M Nance

Bryan Lau

Anthony T Fojo

Heidi E Hutton

Joseph A C Delaney

Heidi M Crane

Karen L Cropsey

Kenneth H Mayer

Sonia Napravnik

Elvin Geng

W Christopher Mathews

Mary E McCaul

Geetanjali Chander

Affiliations

Soon will be listed here.

Abstract

We examined HIV viral load non-suppression ([Formula: see text] 200 copies/mL) subsequent to person-periods (3-18 months) bookended by two self-reports of alcohol use on a standardized patient reported outcome assessment among adults in routine HIV care. We examined the relative risk (RR) of non-suppression associated with increases and decreases in alcohol use (relative to stable use), stratified by use at the start of the person-period. Increases in drinking from abstinence were associated with higher risk of viral non-suppression (low-risk without binge: RR 1.16, 95% CI 1.03, 1.32; low-risk with binge: RR 1.35, 95% CI 1.11, 1.63; high-risk: RR 1.89, 95% CI 1.16, 3.08). Decreases in drinking from high-risk drinking were weakly, and not statistically significantly associated with lower risk of viral non-suppression. Other changes in alcohol use were not associated with viral load non-suppression. Most changes in alcohol consumption among people using alcohol at baseline were not strongly associated with viral non-suppression.

Citing Articles

Alcohol use and optimal chronic diseases' treatment outcomes among adults aged 40 years and above in rural South Africa.

Mupfuti R, Kabudula C, Francis J Sci Rep. 2025; 15(1):7951.

PMID: 40055425 PMC: 11889103. DOI: 10.1038/s41598-025-91704-7.

Differential Associations of Depressive Symptomology to HIV Care Engagement Among Young Black Sexual Minority Men with HIV (YBSMM+) in the US South: A Multi-Group Analysis of Mood, Intimate Partner Violence, and Alcohol Use.

Ramos S, Vincent W, Siconolfi D, Pollack L, Horvath K, Campbell C AIDS Behav. 2023; 28(3):774-785.

PMID: 37796375 PMC: 11610748. DOI: 10.1007/s10461-023-04186-x.

The temporal relationship of alcohol use and subsequent self-reported health status among people with HIV.

Pytell J, Li X, Thompson C, Lesko C, McCaul M, Hutton H Am J Med Open. 2023; 9.

PMID: 37476695 PMC: 10357948. DOI: 10.1016/j.ajmo.2022.100020.

Alcohol use and the longitudinal HIV care continuum for people with HIV who enrolled in care between 2011 and 2019.

Lesko C, Gnang J, Fojo A, Hutton H, McCaul M, Delaney J Ann Epidemiol. 2023; 85:6-12.

PMID: 37442307 PMC: 10538410. DOI: 10.1016/j.annepidem.2023.07.002.

Characterizing Unhealthy Alcohol Use Patterns and Their Association with Alcohol Use Reduction and Alcohol Use Disorder During Follow-Up in HIV Care.

Davy-Mendez T, Sarovar V, Levine-Hall T, Lea A, Sterling S, Chi F AIDS Behav. 2022; 27(5):1380-1391.

PMID: 36169779 PMC: 10043049. DOI: 10.1007/s10461-022-03873-5.

References

Marshall B, Tate J, McGinnis K, Bryant K, Cook R, Edelman E . Long-term alcohol use patterns and HIV disease severity. AIDS. 2017; 31(9):1313-1321. PMC: 5596310. DOI: 10.1097/QAD.0000000000001473. View

Vallet-Pichard A, Mallet V, Nalpas B, Verkarre V, Nalpas A, Dhalluin-Venier V . FIB-4: an inexpensive and accurate marker of fibrosis in HCV infection. comparison with liver biopsy and fibrotest. Hepatology. 2007; 46(1):32-6. DOI: 10.1002/hep.21669. View

Nance R, Delaney J, Simoni J, Wilson I, Mayer K, Whitney B . HIV Viral Suppression Trends Over Time Among HIV-Infected Patients Receiving Care in the United States, 1997 to 2015: A Cohort Study. Ann Intern Med. 2018; 169(6):376-384. PMC: 6388406. DOI: 10.7326/M17-2242. View

Stevens L, Coresh J, Greene T, Levey A . Assessing kidney function--measured and estimated glomerular filtration rate. N Engl J Med. 2006; 354(23):2473-83. DOI: 10.1056/NEJMra054415. View

Viswanathan S, Detels R, Mehta S, Macatangay B, Kirk G, Jacobson L . Level of adherence and HIV RNA suppression in the current era of highly active antiretroviral therapy (HAART). AIDS Behav. 2014; 19(4):601-11. PMC: 4393774. DOI: 10.1007/s10461-014-0927-4. View

Chander G, Hutton H, Lau B, Xu X, McCaul M . Brief Intervention Decreases Drinking Frequency in HIV-Infected, Heavy Drinking Women: Results of a Randomized Controlled Trial. J Acquir Immune Defic Syndr. 2015; 70(2):137-45. PMC: 4634011. DOI: 10.1097/QAI.0000000000000679. View

Lucas N, Windsor T, Caldwell T, Rodgers B . Psychological distress in non-drinkers: associations with previous heavy drinking and current social relationships. Alcohol Alcohol. 2009; 45(1):95-102. DOI: 10.1093/alcalc/agp080. View

Yehia B, Fleishman J, Metlay J, Moore R, Gebo K . Sustained viral suppression in HIV-infected patients receiving antiretroviral therapy. JAMA. 2012; 308(4):339-42. PMC: 3541503. DOI: 10.1001/jama.2012.5927. View

Bangsberg D . Less than 95% adherence to nonnucleoside reverse-transcriptase inhibitor therapy can lead to viral suppression. Clin Infect Dis. 2006; 43(7):939-41. DOI: 10.1086/507526. View

10.

Naar-King S, Parsons J, Murphy D, Chen X, Harris D, Belzer M . Improving health outcomes for youth living with the human immunodeficiency virus: a multisite randomized trial of a motivational intervention targeting multiple risk behaviors. Arch Pediatr Adolesc Med. 2009; 163(12):1092-8. PMC: 2843389. DOI: 10.1001/archpediatrics.2009.212. View

11.

Williams E, McGinnis K, Tate J, Matson T, Rubinsky A, Bobb J . 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):448-455. PMC: 6594884. DOI: 10.1097/QAI.0000000000002049. View

12.

Bush K, Kivlahan D, McDonell M, Fihn S, Bradley K . 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. DOI: 10.1001/archinte.158.16.1789. View

13.

Wu E, Metzger D, Lynch K, Douglas S . Association between alcohol use and HIV viral load. J Acquir Immune Defic Syndr. 2011; 56(5):e129-30. PMC: 3082398. DOI: 10.1097/QAI.0b013e31820dc1c8. View

14.

Bradley K, DeBenedetti A, Volk R, Williams E, Frank D, Kivlahan D . AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res. 2007; 31(7):1208-17. DOI: 10.1111/j.1530-0277.2007.00403.x. View

15.

Moodie E, Delaney J, Lefebvre G, Platt R . Missing confounding data in marginal structural models: a comparison of inverse probability weighting and multiple imputation. Int J Biostat. 2012; 4(1):Article 13. DOI: 10.2202/1557-4679.1106. View

16.

White I, Royston P, Wood A . Multiple imputation using chained equations: Issues and guidance for practice. Stat Med. 2011; 30(4):377-99. DOI: 10.1002/sim.4067. View

17.

Springer S, Di Paola A, Barbour R, Azar M, Altice F . Extended-release Naltrexone Improves Viral Suppression Among Incarcerated Persons Living with HIV and Alcohol use Disorders Transitioning to the Community: Results From a Double-Blind, Placebo-Controlled Trial. J Acquir Immune Defic Syndr. 2018; 79(1):92-100. PMC: 6092223. DOI: 10.1097/QAI.0000000000001759. View

18.

Matson T, McGinnis K, Rubinsky A, Frost M, Czarnogorski M, Bryant K . Gender and alcohol use: influences on HIV care continuum in a national cohort of patients with HIV. AIDS. 2018; 32(15):2247-2253. PMC: 6136970. DOI: 10.1097/QAD.0000000000001946. View

19.

Williams E, McGinnis K, Bobb J, Rubinsky A, Lapham G, Skanderson M . 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; 189:21-29. PMC: 6344121. DOI: 10.1016/j.drugalcdep.2018.04.022. View

20.

Edelman E, Maisto S, Hansen N, Cutter C, Dziura J, Deng Y . Integrated stepped alcohol treatment for patients with HIV and alcohol use disorder: a randomised controlled trial. Lancet HIV. 2019; 6(8):e509-e517. PMC: 7161741. DOI: 10.1016/S2352-3018(19)30076-1. View