Level of Alcohol Use Associated with HIV Care Continuum Targets in a National U.S. Sample of Persons Living with HIV Receiving Healthcare

Emily C. Williams; Kathleen A. McGinnis; E. Jennifer Edelman; Theresa E. Matson; Adam J. Gordon; Brandon D.L. Marshall; Kendall J. Bryant; Anna D. Rubinsky; Gwen T. Lapham; Derek D. Satre; Julie E. Richards; Sheryl L Catz; David A. Fiellin; Amy C. Justice; Katharine A. Bradley

doi:10.1007/s10461-018-2210-6

Level of Alcohol Use Associated with HIV Care Continuum Targets in a National U.S. Sample of Persons Living with HIV Receiving Healthcare

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

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Abstract

We evaluated associations between levels of alcohol use and HIV care continuum components using national Veterans Aging Cohort Study data for all patients with HIV and AUDIT-C screening (2/1/2008–9/30/2014). Poisson regression models evaluated associations between alcohol use levels (non-drinking, low-, medium-, high-, and very high-level drinking) and: (1) engagement with care (documented CD4 cells/µl or viral load copies/ml labs), (2) ART treatment (≥ 1 prescription), and (3) viral suppression (HIV RNA < 500 copies/ml) within one year. Among 33,224 patients, alcohol use level was inversely associated with all care continuum outcomes (all p < 0.001). Adjusted prevalence of care engagement ranged from 77.8% (95% CI 77.1–78.4%) for non-drinking to 69.1% (66.6–71.6%) for high-level drinking. The corresponding range for ART treatment was 74.0% (73.3–74.7%) to 60.1% (57.3–62.9%) and for viral suppression was 57.3% (56.5–58.1%) to 38.3% (35.6–41.1%). Greater alcohol use is associated with suboptimal HIV treatment across the HIV care continuum.

Original language	English (US)
Pages (from-to)	1-12
Number of pages	12
Journal	AIDS and Behavior
DOIs	https://doi.org/10.1007/s10461-018-2210-6
State	Accepted/In press - Jul 9 2018

Keywords

Alcohol
Antiretroviral therapy
Care continuum
HIV
Treatment cascade
Viral suppression

ASJC Scopus subject areas

Social Psychology
Public Health, Environmental and Occupational Health
Infectious Diseases

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10.1007/s10461-018-2210-6

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Williams, E. C., McGinnis, K. A., Edelman, E. J., Matson, T. E., Gordon, A. J., Marshall, B. D. L., Bryant, K. J., Rubinsky, A. D., Lapham, G. T., Satre, D. D., Richards, J. E., Catz, S. L., Fiellin, D. A., Justice, A. C., & Bradley, K. A. (Accepted/In press). Level of Alcohol Use Associated with HIV Care Continuum Targets in a National U.S. Sample of Persons Living with HIV Receiving Healthcare. AIDS and Behavior, 1-12. https://doi.org/10.1007/s10461-018-2210-6

Level of Alcohol Use Associated with HIV Care Continuum Targets in a National U.S. Sample of Persons Living with HIV Receiving Healthcare. / Williams, Emily C.; McGinnis, Kathleen A.; Edelman, E. Jennifer; Matson, Theresa E.; Gordon, Adam J.; Marshall, Brandon D.L.; Bryant, Kendall J.; Rubinsky, Anna D.; Lapham, Gwen T.; Satre, Derek D.; Richards, Julie E.; Catz, Sheryl L; Fiellin, David A.; Justice, Amy C.; Bradley, Katharine A.

In: AIDS and Behavior, 09.07.2018, p. 1-12.

Research output: Contribution to journal › Article › peer-review

Williams, EC, McGinnis, KA, Edelman, EJ, Matson, TE, Gordon, AJ, Marshall, BDL, Bryant, KJ, Rubinsky, AD, Lapham, GT, Satre, DD, Richards, JE, Catz, SL, Fiellin, DA, Justice, AC & Bradley, KA 2018, 'Level of Alcohol Use Associated with HIV Care Continuum Targets in a National U.S. Sample of Persons Living with HIV Receiving Healthcare', AIDS and Behavior, pp. 1-12. https://doi.org/10.1007/s10461-018-2210-6

Williams, Emily C. ; McGinnis, Kathleen A. ; Edelman, E. Jennifer ; Matson, Theresa E. ; Gordon, Adam J. ; Marshall, Brandon D.L. ; Bryant, Kendall J. ; Rubinsky, Anna D. ; Lapham, Gwen T. ; Satre, Derek D. ; Richards, Julie E. ; Catz, Sheryl L ; Fiellin, David A. ; Justice, Amy C. ; Bradley, Katharine A. / Level of Alcohol Use Associated with HIV Care Continuum Targets in a National U.S. Sample of Persons Living with HIV Receiving Healthcare. In: AIDS and Behavior. 2018 ; pp. 1-12.

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abstract = "We evaluated associations between levels of alcohol use and HIV care continuum components using national Veterans Aging Cohort Study data for all patients with HIV and AUDIT-C screening (2/1/2008–9/30/2014). Poisson regression models evaluated associations between alcohol use levels (non-drinking, low-, medium-, high-, and very high-level drinking) and: (1) engagement with care (documented CD4 cells/µl or viral load copies/ml labs), (2) ART treatment (≥ 1 prescription), and (3) viral suppression (HIV RNA < 500 copies/ml) within one year. Among 33,224 patients, alcohol use level was inversely associated with all care continuum outcomes (all p < 0.001). Adjusted prevalence of care engagement ranged from 77.8% (95% CI 77.1–78.4%) for non-drinking to 69.1% (66.6–71.6%) for high-level drinking. The corresponding range for ART treatment was 74.0% (73.3–74.7%) to 60.1% (57.3–62.9%) and for viral suppression was 57.3% (56.5–58.1%) to 38.3% (35.6–41.1%). Greater alcohol use is associated with suboptimal HIV treatment across the HIV care continuum.",

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AU - Matson, Theresa E.

AU - Gordon, Adam J.

AU - Marshall, Brandon D.L.

AU - Bryant, Kendall J.

AU - Rubinsky, Anna D.

AU - Lapham, Gwen T.

AU - Satre, Derek D.

AU - Richards, Julie E.

AU - Catz, Sheryl L

AU - Fiellin, David A.

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AU - Bradley, Katharine A.

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Level of Alcohol Use Associated with HIV Care Continuum Targets in a National U.S. Sample of Persons Living with HIV Receiving Healthcare

Abstract

Keywords

ASJC Scopus subject areas

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