Not all non-drinkers with HIV are equal: demographic and clinical comparisons among current non-drinkers with and without a history of prior alcohol use disorders

Heidi M Crane¹, Robin M Nance¹, Joseph O Merrill¹, Heidi Hutton², Geetanjali Chander³, Mary E McCaul², W Chris Mathews⁴, Rob Fredericksen¹, Jane M Simoni⁵, Kenneth Mayer⁶, Michael J Mugavero⁷, James H Willig⁷, Greer Burkholder⁷, Daniel R Drozd¹, Matthew Mimiaga⁸, Bryan Lau⁹, H Nina Kim¹, Karen Cropsey¹⁰, Richard D Moore³, Katerina Christopoulos¹¹, Elvin Geng¹¹, Joseph J Eron¹², Sonia Napravnik¹², Mari M Kitahata¹, Michael S Saag⁷, Joseph Ac Delaney¹³

Affiliations

¹ a Department of Medicine , University of Washington , Seattle , WA , USA.
² b Department of Psychiatry and Behavioral Sciences , Johns Hopkins University , Baltimore , MD , USA.
³ c Department of Medicine , Johns Hopkins University , Baltimore , MD , USA.
⁴ d Department of Medicine , University of California , San Diego , CA , USA.
⁵ e Department of Psychology , University of Washington , Seattle , WA , USA.
⁶ f Fenway Institute and Department of Medicine , Harvard Medical School , Boston , MA , USA.
⁷ g Department of Medicine , University of Alabama at Birmingham , Birmingham , AL , USA.
⁸ h Departments of Behavioral and Social Sciences , Brown University , Providence , RI , USA.
⁹ i Department of Epidemiology , Johns Hopkins University , Baltimore , MD , USA.
¹⁰ j Department of Psychiatry , University of Alabama at Birmingham , Birmingham , AL , USA.
¹¹ k Department of Medicine , University of California at San Francisco , San Francisco , CA , USA.
¹² l Department of Medicine , University of North Carolina , Chapel Hill , NC , USA.
¹³ m Department of Epidemiology , University of Washington , Seattle , WA , USA.

PMID: 27482893
PMCID: PMC5628736
DOI: 10.1080/09540121.2016.1204418

Observational Study

Not all non-drinkers with HIV are equal: demographic and clinical comparisons among current non-drinkers with and without a history of prior alcohol use disorders

Heidi M Crane et al. AIDS Care. 2017 Feb.

. 2017 Feb;29(2):177-184.

doi: 10.1080/09540121.2016.1204418. Epub 2016 Aug 2.

Authors

Affiliations

¹ a Department of Medicine , University of Washington , Seattle , WA , USA.
² b Department of Psychiatry and Behavioral Sciences , Johns Hopkins University , Baltimore , MD , USA.
³ c Department of Medicine , Johns Hopkins University , Baltimore , MD , USA.
⁴ d Department of Medicine , University of California , San Diego , CA , USA.
⁵ e Department of Psychology , University of Washington , Seattle , WA , USA.
⁶ f Fenway Institute and Department of Medicine , Harvard Medical School , Boston , MA , USA.
⁷ g Department of Medicine , University of Alabama at Birmingham , Birmingham , AL , USA.
⁸ h Departments of Behavioral and Social Sciences , Brown University , Providence , RI , USA.
⁹ i Department of Epidemiology , Johns Hopkins University , Baltimore , MD , USA.
¹⁰ j Department of Psychiatry , University of Alabama at Birmingham , Birmingham , AL , USA.
¹¹ k Department of Medicine , University of California at San Francisco , San Francisco , CA , USA.
¹² l Department of Medicine , University of North Carolina , Chapel Hill , NC , USA.
¹³ m Department of Epidemiology , University of Washington , Seattle , WA , USA.

PMID: 27482893
PMCID: PMC5628736
DOI: 10.1080/09540121.2016.1204418

Abstract

Studies of persons living with HIV (PLWH) have compared current non-drinkers to at-risk drinkers without differentiating whether current non-drinkers had a prior alcohol use disorder (AUD). The purpose of this study was to compare current non-drinkers with and without a prior AUD on demographic and clinical characteristics to understand the impact of combining them. We included data from six sites across the US from 1/2013 to 3/2015. Patients completed tablet-based clinical assessments at routine clinic appointments using the most recent assessment. Current non-drinkers were identified by AUDIT-C scores of 0. We identified a prior probable AUD by a prior AUD diagnosis in the electronic medical record (EMR) or a report of attendance at alcohol treatment in the clinical assessment. We used multivariate logistic regression to examine factors associated with prior AUD. Among 2235 PLWH who were current non-drinkers, 36% had a prior AUD with more patients with an AUD identified by the clinical assessment than the EMR. Higher proportions with a prior AUD were male, depressed, and reported current drug use compared to non-drinkers without a prior AUD. Former cocaine/crack (70% vs. 25%), methamphetamine/crystal (49% vs. 16%), and opioid/heroin use (35% vs. 7%) were more commonly reported by those with a prior AUD. In adjusted analyses, male sex, past methamphetamine/crystal use, past marijuana use, past opioid/heroin use, past and current cocaine/crack use, and cigarette use were associated with a prior AUD. In conclusion, this study found that among non-drinking PLWH in routine clinical care, 36% had a prior AUD. We found key differences between those with and without prior AUD in demographic and clinical characteristics, including drug use and depression. These results suggest that non-drinkers are heterogeneous and need further differentiation in studies and that prior alcohol misuse (including alcohol treatment) should be included in behavioural health assessments as part of clinical care.

Keywords: HIV; adherence; alcohol use; alcohol use disorders; substance use.

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Conflict of interest statement

Conflicts of interest: There are no conflicts of interest for this paper.

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Not all non-drinkers with HIV are equal: demographic and clinical comparisons among current non-drinkers with and without a history of prior alcohol use disorders

Affiliations

Not all non-drinkers with HIV are equal: demographic and clinical comparisons among current non-drinkers with and without a history of prior alcohol use disorders

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Miscellaneous