The Association Between Changes in Alcohol Use and Changes in Antiretroviral Therapy Adherence and Viral Suppression Among Women Living with HIV

doi:10.1007/s10461-016-1580-x

. 2017 Jul;21(7):1836-1845.

doi: 10.1007/s10461-016-1580-x.

The Association Between Changes in Alcohol Use and Changes in Antiretroviral Therapy Adherence and Viral Suppression Among Women Living with HIV

Nikita Barai¹, Anne Monroe^{2

3}, Catherine Lesko⁴, Bryan Lau⁴, Heidi Hutton⁵, Cui Yang⁶, Anika Alvanzo¹, Mary Elizabeth McCaul⁵, Geetanjali Chander^{1

4}

Affiliations

¹ Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street #8060, Baltimore, MD, 21287, USA.
² Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street #8060, Baltimore, MD, 21287, USA. amonroe4@jhmi.edu.
³ Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. amonroe4@jhmi.edu.
⁴ Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
⁵ Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁶ Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA.

PMID: 27752873
PMCID: PMC5393959
DOI: 10.1007/s10461-016-1580-x

The Association Between Changes in Alcohol Use and Changes in Antiretroviral Therapy Adherence and Viral Suppression Among Women Living with HIV

Nikita Barai et al. AIDS Behav. 2017 Jul.

. 2017 Jul;21(7):1836-1845.

doi: 10.1007/s10461-016-1580-x.

Authors

Nikita Barai¹, Anne Monroe^{2

3}, Catherine Lesko⁴, Bryan Lau⁴, Heidi Hutton⁵, Cui Yang⁶, Anika Alvanzo¹, Mary Elizabeth McCaul⁵, Geetanjali Chander^{1

4}

Affiliations

¹ Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street #8060, Baltimore, MD, 21287, USA.
² Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street #8060, Baltimore, MD, 21287, USA. amonroe4@jhmi.edu.
³ Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. amonroe4@jhmi.edu.
⁴ Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
⁵ Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁶ Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA.

PMID: 27752873
PMCID: PMC5393959
DOI: 10.1007/s10461-016-1580-x

Abstract

Heavy alcohol use has adverse effects in women with HIV. We examined the association between changes in alcohol use (measured with Timeline Followback) and changes in antiretroviral therapy adherence (medication possession ratio) and viral suppression (HIV RNA), measured over 6-month intervals. Among women who were (1) non-adherent or not virologically suppressed and (2) infrequent binge drinkers or non-heavy drinkers at baseline, increasing drinking was significantly associated with lower odds of subsequently improving adherence or viral suppression (OR of becoming adherent of 0.90 in infrequent binge drinkers; OR of becoming suppressed of 0.81 and 0.75 in infrequent binge drinkers and non-heavy drinkers, respectively). Our findings suggest that for these women, increasing drinking may be a barrier to achieving viral suppression. Addressing this barrier by integrating proactive alcohol counseling strategies into routine HIV care may be key to improving viral suppression rates among women retained in HIV care.

Keywords: Alcohol; Antiretroviral medication adherence; HIV infection; Viral load; Women.

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Conflict of interest statement

Conflict of Interest: Dr. Barai declares that she has no conflict of interest. Dr. Monroe declares that she has no conflict of interest. Dr. Lesko declares that she has no conflict of interest. Dr. Lau declares that he has no conflict of interest. Dr. Hutton declares that she has no conflict of interest. Dr. Yang declares that she has no conflict of interest. Dr. Alvanzo declares that she has no conflict of interest. Dr. McCaul declares that she has no conflict of interest. Dr. Chander declares that she has no conflict of interest.

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References

1. CDC. HIV Among Women. Avaiable at: http://www.cdc.gov/hiv/group/gender/women/. Accessed: January 11, 2016.
1. Fagbami O, Oluwasanjo A, Fitzpatrick C, Fairchild R, Shin A, Donato A. Factors supporting and inhibiting adherence to HIV medication regimen in women: a qualitative analysis of patient interviews. Open AIDS J. 2015;9:45–50. - PMC - PubMed
1. Cohen MH, Cook JA, Grey D, et al. Medically eligible women who do not use HAART: the importance of abuse, drug use, and race. Am J Public Health. 2004;94(7):1147–51. - PMC - PubMed
1. Turner BJ, Laine C, Cosler L, Hauck WW. Relationship of gender, depression, and health care delivery with antiretroviral adherence in HIV‐infected drug users. J Gen Intern Med. 2003;18(4):248–57. - PMC - PubMed
1. Murphy DA, Greenwell L, Hoffman D. Factors associated with antiretroviral adherence among HIV-infected women with children. Women Health. 2002;36(1):97–111. - PubMed

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[1] CDC. HIV Among Women. Avaiable at: http://www.cdc.gov/hiv/group/gender/women/. Accessed: January 11, 2016.

[2] CDC. HIV Among Women. Avaiable at: http://www.cdc.gov/hiv/group/gender/women/. Accessed: January 11, 2016.

[3] Fagbami O, Oluwasanjo A, Fitzpatrick C, Fairchild R, Shin A, Donato A. Factors supporting and inhibiting adherence to HIV medication regimen in women: a qualitative analysis of patient interviews. Open AIDS J. 2015;9:45–50. - PMC - PubMed

[4] Fagbami O, Oluwasanjo A, Fitzpatrick C, Fairchild R, Shin A, Donato A. Factors supporting and inhibiting adherence to HIV medication regimen in women: a qualitative analysis of patient interviews. Open AIDS J. 2015;9:45–50. - PMC - PubMed

[5] Cohen MH, Cook JA, Grey D, et al. Medically eligible women who do not use HAART: the importance of abuse, drug use, and race. Am J Public Health. 2004;94(7):1147–51. - PMC - PubMed

[6] Cohen MH, Cook JA, Grey D, et al. Medically eligible women who do not use HAART: the importance of abuse, drug use, and race. Am J Public Health. 2004;94(7):1147–51. - PMC - PubMed

[7] Turner BJ, Laine C, Cosler L, Hauck WW. Relationship of gender, depression, and health care delivery with antiretroviral adherence in HIV‐infected drug users. J Gen Intern Med. 2003;18(4):248–57. - PMC - PubMed

[8] Turner BJ, Laine C, Cosler L, Hauck WW. Relationship of gender, depression, and health care delivery with antiretroviral adherence in HIV‐infected drug users. J Gen Intern Med. 2003;18(4):248–57. - PMC - PubMed

[9] Murphy DA, Greenwell L, Hoffman D. Factors associated with antiretroviral adherence among HIV-infected women with children. Women Health. 2002;36(1):97–111. - PubMed

[10] Murphy DA, Greenwell L, Hoffman D. Factors associated with antiretroviral adherence among HIV-infected women with children. Women Health. 2002;36(1):97–111. - PubMed

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The Association Between Changes in Alcohol Use and Changes in Antiretroviral Therapy Adherence and Viral Suppression Among Women Living with HIV

Affiliations

The Association Between Changes in Alcohol Use and Changes in Antiretroviral Therapy Adherence and Viral Suppression Among Women Living with HIV

Authors

Affiliations

Abstract

Conflict of interest statement

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