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. 2019 Aug;31(8):951-957.
doi: 10.1080/09540121.2019.1587357. Epub 2019 Mar 18.

Alcohol-related intentional nonadherence to antiretroviral therapy among people living with HIV, Cape Town, South Africa

Seth Kalichman  1 , Catherine Mathews  2 , Ellen Banas  1   2 , Moira Kalichman  1
Affiliations

Alcohol-related intentional nonadherence to antiretroviral therapy among people living with HIV, Cape Town, South Africa

Seth Kalichman et al. AIDS Care. 2019 Aug.

Abstract

Alcohol use may have significant negative impacts on individuals' ability to remain adherent to antiretroviral therapy (ART), and may also yield other negative psychosocial, health-related, and behavioral outcomes. In addition, false beliefs about the consequences of mixing alcohol with ART use may cause individuals to avoid taking ART when drinking (alcohol-related ART avoidance). Although research conducted in the U.S. and Europe has reported on alcohol-ART avoidance, the current study presents among the first quantitative evidence of alcohol-related intentional ART nonadherence in South Africa. Patients receiving ART from a community clinic in Cape Town (N = 441) completed anonymous surveys of alcohol use, ART adherence, and alcohol-ART avoidance. Results showed that 292 (66%) participants reported current alcohol use; 25% who use alcohol believed that people who drink should stop taking ART when they are drinking and 24% stop their own ART when drinking. Alcohol-ART avoidance mediated the association between alcohol use and ART adherence. Results were robust when controlling for participant age, gender, current care status, and first- versus second-line ART. We found alcohol-ART avoidance may threaten successful ART in South Africa. Corrective messages that take a harm reduction approach to maximize ART adherence when drinking should be implemented in existing clinical services.

Keywords: HIV care barriers; HIV treatment; alcohol use; antiretroviral adherence.

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Figures

Figure 1
Figure 1
Mediation model of the effects of alcohol consumption on ART adherence through alcohol-ART avoidance.
See this image and copyright information in PMC

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