Alcohol Use and Antiretroviral Adherence Among Patients Living with HIV: Is Change in Alcohol Use Associated with Change in Adherence?

Emily C. Williams, Kathleen A. McGinnis, Anna D. Rubinsky, Theresa E. Matson, Jennifer F. Bobb, Gwen T. Lapham, E. Jennifer Edelman, Derek D. Satre, Sheryl L. Catz, Julie E. Richards, Kendall J. Bryant, Brandon D.L. Marshall, Kevin L. Kraemer, Stephen Crystal, Adam J. Gordon, Melissa Skanderson, David A. Fiellin, Amy C. Justice, Katharine A. Bradley

Research output: Contribution to journalArticle

Abstract

Alcohol use increases non-adherence to antiretroviral therapy (ART) among persons living with HIV (PLWH). Dynamic longitudinal associations are understudied. Veterans Aging Cohort Study (VACS) data 2/1/2008–7/31/16 were used to fit linear regression models estimating changes in adherence (% days with ART medication fill) associated with changes in alcohol use based on annual clinically-ascertained AUDIT-C screening scores (range − 12 to + 12, 0 = no change) adjusting for demographics and initial adherence. Among 21,275 PLWH (67,330 observations), most reported no (48%) or low-level (39%) alcohol use initially, with no (55%) or small (39% ≤ 3 points) annual change. Mean initial adherence was 86% (SD 21%), mean annual change was − 3.1% (SD 21%). An inverted V-shaped association was observed: both increases and decreases in AUDIT-C were associated with greater adherence decreases relative to stable scores [p < 0.001, F (4, 21,274)]. PLWH with dynamic alcohol use (potentially indicative of alcohol use disorder) should be considered for adherence interventions.

Original languageEnglish (US)
JournalAIDS and Behavior
DOIs
StateAccepted/In press - 2020

Keywords

  • Adherence
  • Alcohol use
  • Antiretroviral therapy
  • ART
  • HIV

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Fingerprint Dive into the research topics of 'Alcohol Use and Antiretroviral Adherence Among Patients Living with HIV: Is Change in Alcohol Use Associated with Change in Adherence?'. Together they form a unique fingerprint.

  • Cite this

    Williams, E. C., McGinnis, K. A., Rubinsky, A. D., Matson, T. E., Bobb, J. F., Lapham, G. T., Edelman, E. J., Satre, D. D., Catz, S. L., Richards, J. E., Bryant, K. J., Marshall, B. D. L., Kraemer, K. L., Crystal, S., Gordon, A. J., Skanderson, M., Fiellin, D. A., Justice, A. C., & Bradley, K. A. (Accepted/In press). Alcohol Use and Antiretroviral Adherence Among Patients Living with HIV: Is Change in Alcohol Use Associated with Change in Adherence? AIDS and Behavior. https://doi.org/10.1007/s10461-020-02950-x