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. 2008 Sep;27(5):628-37.
doi: 10.1037/a0012664.

The temporal relationship between alcohol consumption and HIV-medication adherence: a multilevel model of direct and moderating effects

Jeffrey T Parsons  1 , Elana Rosof, Brian Mustanski
Affiliations

The temporal relationship between alcohol consumption and HIV-medication adherence: a multilevel model of direct and moderating effects

Jeffrey T Parsons et al. Health Psychol. 2008 Sep.

Abstract

Previous studies documenting an association between alcohol use and HIV medication nonadherence, have been unable to distinguish between-persons characteristics from within-person characteristics representing the temporally linked effects of alcohol. Hierarchical Linear Modeling (HLM) explored within- and between-person predictors of adherence during the past 14 days, as well as factors that moderate the event-level effects of alcohol consumption among 272 HIV-positive men and women with alcohol problems. On days in which participants drank, they had almost 9 times higher odds of medication nonadherence, with each drink increasing the odds by 20%. The cognitive and alcohol factors had significant between-person effects on adherence. Individuals with strong and rigid beliefs about the importance of strict medication adherence were significantly more affected by each dose of alcohol, while individuals with more alcohol use and problems were less affected by each drink. Regimen complexity increased the effects of having 1 or more drinks. These results highlight the importance of promoting medication adherence among alcohol-using adults, especially among patients with complex regimens or with high confidence and positive attitudes toward HIV medication.

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Figures

Figure 1
Figure 1
(A) Cognitive factors moderate the relationship between number of standard drinks and medication adherence. (B) Alcohol factors moderate the relationship between number of standard drinks and medication adherence. Medication nonadherence was coded so that 0 = adherent and 1 = nonadherent. COGNITIV represents the standardized Cognitive factor score. ALCOHOL represents the standardized Alcohol factor score.
Figure 2
Figure 2
Regimen complexity moderated the relationship between dichotomous alcohol consumption and medication adherence. Medication nonadherence was coded so that 0 = adherent and 1 = nonadherent. REGIMEN represents the sum of total number of dosing times and the total number of HAART pills taken per day.
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