Abstract
BACKGROUND: Alcohol use influences HIV disease severity through multiple mechanisms. Whether HIV disease severity is sensitive to changes in alcohol use among people with HIV (PWH) is understudied. SETTING: National Veterans Health Administration. METHODS: Pairs of AUDIT-C screens within 9-15 months (February 1, 2008-September 30, 2014) were identified among PWH from the Veterans Aging Cohort Study (VACS). Initial and follow-up VACS Index 2.0 pairs obtained 0-270 days after initial and follow-up AUDIT-Cs, respectively, determined change in VACS Index 2.0, a composite HIV severity measure. Change in VACS Index 2.0 was regressed on AUDIT-C change scores (-12 to +12) adjusted for demographics, initial VACS Index 2.0, and days between VACS Index measures. RESULTS: Among 23,297 PWH (76,202 observations), most had no (51%) or low-level (38%) alcohol use initially. Most (54%) had no subsequent change; 21% increased and 24% decreased drinking. Initial VACS Index 2.0 scores ranged from 0 to 134, change scores ranged from -65 to +73, with average improvement of 0.76 points (SD 9.48). AUDIT-C change was associated with VACS Index 2.0 change (P < 0.001). Among those with stable alcohol use (AUDIT-C change ≤ │1│ point), VACS Index 2.0 improvements ranged 0.36-0.60 points. For those with maximum AUDIT-C increase (change from 0 to 12), VACS Index 2.0 worsened 3.74 points (95% CI: -4.71 to -2.78); for those with maximum AUDIT-C decrease (change from 12 to 0), VACS Index 2.0 changed minimally [-0.60 (95% CI: -1.43 to 0.23)]. CONCLUSIONS: In this national sample, improvement in HIV severity was generally greatest among those with stable alcohol use (primarily those with no use).
| Original language | English (US) |
|---|---|
| Pages (from-to) | 448-455 |
| Number of pages | 8 |
| Journal | Journal of acquired immune deficiency syndromes (1999) |
| Volume | 81 |
| Issue number | 4 |
| DOIs | |
| State | Published - Aug 1 2019 |
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ASJC Scopus subject areas
- Infectious Diseases
- Pharmacology (medical)
Cite this
HIV Disease Severity Is Sensitive to Temporal Changes in Alcohol Use : A National Study of VA Patients With HIV. / Williams, Emily C.; McGinnis, Kathleen A.; Tate, Janet P.; Matson, Theresa E.; Rubinsky, Anna D.; Bobb, Jennifer F.; Lapham, Gwen T.; Edelman, E. Jennifer; Catz, Sheryl L; Satre, Derek D.; Bryant, Kendall J.; Marshall, Brandon D.L.; Kraemer, Kevin L.; Bensley, Kara M.; Richards, Julie E.; Skanderson, Melissa; Justice, Amy C.; Fiellin, David A.; Bradley, Katharine A.
In: Journal of acquired immune deficiency syndromes (1999), Vol. 81, No. 4, 01.08.2019, p. 448-455.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - HIV Disease Severity Is Sensitive to Temporal Changes in Alcohol Use
T2 - A National Study of VA Patients With HIV
AU - Williams, Emily C.
AU - McGinnis, Kathleen A.
AU - Tate, Janet P.
AU - Matson, Theresa E.
AU - Rubinsky, Anna D.
AU - Bobb, Jennifer F.
AU - Lapham, Gwen T.
AU - Edelman, E. Jennifer
AU - Catz, Sheryl L
AU - Satre, Derek D.
AU - Bryant, Kendall J.
AU - Marshall, Brandon D.L.
AU - Kraemer, Kevin L.
AU - Bensley, Kara M.
AU - Richards, Julie E.
AU - Skanderson, Melissa
AU - Justice, Amy C.
AU - Fiellin, David A.
AU - Bradley, Katharine A.
PY - 2019/8/1
Y1 - 2019/8/1
N2 - BACKGROUND: Alcohol use influences HIV disease severity through multiple mechanisms. Whether HIV disease severity is sensitive to changes in alcohol use among people with HIV (PWH) is understudied. SETTING: National Veterans Health Administration. METHODS: Pairs of AUDIT-C screens within 9-15 months (February 1, 2008-September 30, 2014) were identified among PWH from the Veterans Aging Cohort Study (VACS). Initial and follow-up VACS Index 2.0 pairs obtained 0-270 days after initial and follow-up AUDIT-Cs, respectively, determined change in VACS Index 2.0, a composite HIV severity measure. Change in VACS Index 2.0 was regressed on AUDIT-C change scores (-12 to +12) adjusted for demographics, initial VACS Index 2.0, and days between VACS Index measures. RESULTS: Among 23,297 PWH (76,202 observations), most had no (51%) or low-level (38%) alcohol use initially. Most (54%) had no subsequent change; 21% increased and 24% decreased drinking. Initial VACS Index 2.0 scores ranged from 0 to 134, change scores ranged from -65 to +73, with average improvement of 0.76 points (SD 9.48). AUDIT-C change was associated with VACS Index 2.0 change (P < 0.001). Among those with stable alcohol use (AUDIT-C change ≤ │1│ point), VACS Index 2.0 improvements ranged 0.36-0.60 points. For those with maximum AUDIT-C increase (change from 0 to 12), VACS Index 2.0 worsened 3.74 points (95% CI: -4.71 to -2.78); for those with maximum AUDIT-C decrease (change from 12 to 0), VACS Index 2.0 changed minimally [-0.60 (95% CI: -1.43 to 0.23)]. CONCLUSIONS: In this national sample, improvement in HIV severity was generally greatest among those with stable alcohol use (primarily those with no use).
AB - BACKGROUND: Alcohol use influences HIV disease severity through multiple mechanisms. Whether HIV disease severity is sensitive to changes in alcohol use among people with HIV (PWH) is understudied. SETTING: National Veterans Health Administration. METHODS: Pairs of AUDIT-C screens within 9-15 months (February 1, 2008-September 30, 2014) were identified among PWH from the Veterans Aging Cohort Study (VACS). Initial and follow-up VACS Index 2.0 pairs obtained 0-270 days after initial and follow-up AUDIT-Cs, respectively, determined change in VACS Index 2.0, a composite HIV severity measure. Change in VACS Index 2.0 was regressed on AUDIT-C change scores (-12 to +12) adjusted for demographics, initial VACS Index 2.0, and days between VACS Index measures. RESULTS: Among 23,297 PWH (76,202 observations), most had no (51%) or low-level (38%) alcohol use initially. Most (54%) had no subsequent change; 21% increased and 24% decreased drinking. Initial VACS Index 2.0 scores ranged from 0 to 134, change scores ranged from -65 to +73, with average improvement of 0.76 points (SD 9.48). AUDIT-C change was associated with VACS Index 2.0 change (P < 0.001). Among those with stable alcohol use (AUDIT-C change ≤ │1│ point), VACS Index 2.0 improvements ranged 0.36-0.60 points. For those with maximum AUDIT-C increase (change from 0 to 12), VACS Index 2.0 worsened 3.74 points (95% CI: -4.71 to -2.78); for those with maximum AUDIT-C decrease (change from 12 to 0), VACS Index 2.0 changed minimally [-0.60 (95% CI: -1.43 to 0.23)]. CONCLUSIONS: In this national sample, improvement in HIV severity was generally greatest among those with stable alcohol use (primarily those with no use).
UR - http://www.scopus.com/inward/record.url?scp=85068886877&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85068886877&partnerID=8YFLogxK
U2 - 10.1097/QAI.0000000000002049
DO - 10.1097/QAI.0000000000002049
M3 - Article
C2 - 30973541
AN - SCOPUS:85068886877
VL - 81
SP - 448
EP - 455
JO - Journal of acquired immune deficiency syndromes (1999)
JF - Journal of acquired immune deficiency syndromes (1999)
SN - 1525-4135
IS - 4
ER -