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; Rubinsky, Anna D.; Lapham, Gwen T.; Satre, Derek D.; Richards, Julie; Catz, Sheryl L.; Fiellin, David A.; Justice, Amy C.; Bradley, Katharine A.

doi:10.1007/s10461-018-2210-6

Cited by 78 publications

(62 citation statements)

References 61 publications

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“…AUD is a significant comorbidity in PLWH contributing to poor health outcomes (Vagenas et al, 2015; Edelman et al, 2018). Alcohol use disorder interferes with HIV disease management on multiple levels which impact the HIV care continuum (Claborn et al, 2018; Vagenas et al, 2015; Williams et al, 2019). However, the evidence of physiological consequences of alcohol use among PLWH is limited due to the tools used to assess and measure alcohol use frequency, quantity, duration, and patterns.…”

mentioning

confidence: 99%

Comprehensive Assessment of Alcohol Consumption in People Living with HIV (PLWH): The New Orleans Alcohol Use in HIV Study

Ferguson

Theall

Brashear

et al. 2020

Alcoholism Clin & Exp Res

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Background: High frequency of alcohol use among people living with HIV (PLWH) warrants careful assessment and screening to better understand its impact on HIV disease progression and development of comorbidities. Due to the limitations of the tools used to measure alcohol use, the links to health consequences are not fully understood.Methods: We completed a cross-sectional analysis to examine the prevalence of alcohol consumption using multiple alcohol assessment tools and their correlation and consistency in a cohort of PLWH (N = 365) enrolled in the New Orleans Alcohol Use in HIV (NOAH) Study. Alcohol use was assessed with the Alcohol Use Disorders Identification Test (AUDIT), timeline followback (TLFB) Calendar, lifetime drinking history, Alcohol and Drug Addiction Severity Index, and blood levels of phosphatidylethanol (PEth). Spearman's correlations were estimated for continuous measures of alcohol consumption; Wilcoxon rank-sum tests were used to compare means; and logistic regression was used to estimate odds of alcohol use by demographic characteristics.Results: Self-report of current alcohol use varied from 58.9 to 73.7% depending on the assessment. All the self-reported alcohol measures showed statistically significant correlations with the biological marker PEth. The highest correlation was with TLFB grams (r = 0.67, p < 0.001). Using TLFB, 73.7% of the cohort reported using alcohol in the last 30 days, and 61.6% had a positive PEth value. The prevalence of risky drinkers, meeting the TLFB > 3 (women) or >4 (men) drinks/day or>7 (women) or>14 (men) drinks/week, was 49.0%. Medium-risk drinking defined as an AUDIT score ≥ 8 was reported in 40.3%, and high-risk drinkers/probable AUD (AUDIT score ≥ 16) was met by 17.0% of the cohort.Conclusions: Our results demonstrate the importance of comprehensive assessments for alcohol use, including self-report via multiple assessment tools administered by trained staff, as well as the addition of biomarkers for improved classification of subjects into different drinking categories.

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confidence: 99%

Comprehensive Assessment of Alcohol Consumption in People Living with HIV (PLWH): The New Orleans Alcohol Use in HIV Study

Ferguson

Theall

Brashear

et al. 2020

Alcoholism Clin & Exp Res

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“…2 Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT 06510, USA. 3 Syracuse University, Syracuse, NY 13244, USA. 4 College of Public Health, University of Georgia, Athens, GA 30602, USA.…”

Section: Supplementary Informationmentioning

confidence: 99%

“…may interfere with achievement of HIV viral suppression [3], increase risk of morbidity and mortality [4][5][6], and lead to risk behaviors and ongoing HIV transmission [7]. Accordingly, guidelines recommend that patients with atrisk alcohol use, including those with HIV, should receive brief interventions with subsequent treatment to reduce their alcohol use [8,9] and integrated with HIV care [10].…”

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confidence: 99%

Integrated stepped alcohol treatment for patients with HIV and at-risk alcohol use: a randomized trial

Edelman

Maisto

Hansen

et al. 2020

Addict Sci Clin Pract

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Background: At-risk levels of alcohol use threaten the health of patients with HIV (PWH), yet evidence-based strategies to decrease alcohol use and improve HIV-related outcomes in this population are lacking. We examined the effectiveness of integrated stepped alcohol treatment (ISAT) on alcohol use and HIV outcomes among PWH and at-risk alcohol use. Methods: In this multi-site, randomized trial conducted between January 28, 2013 through July 14, 2017, we enrolled PWH and at-risk alcohol use [defined as alcohol consumption of ≥ 14 drinks per week or ≥ 4 drinks per occasion in men ≤ 65 years old or ≥ 7 drinks per week or ≥ 3 drinks per occasion in women or men > 65 years old]. ISAT (n = 46) involved: Step 1-Brief Negotiated Interview with telephone booster, Step 2-Motivational Enhancement Therapy, and Step 3-Addiction Physician Management. Treatment as usual (TAU) (n = 47) involved receipt of a health handout plus routine care. Analyses were conducted based on intention to treat principles. Results: Despite a multi-pronged approach, we only recruited 37% of the target population (n = 93/254). Among ISAT participants, 50% advanced to Step 2, among whom 57% advanced to Step 3. Participants randomized to ISAT and TAU had no observed difference in drinks per week over the past 30 days at week 24 (primary outcome) [least square means (Ls mean) (95% CI) = 8.8 vs. 10.6; adjusted mean difference (AMD) (95% CI) = − 0.4 (− 3.9, 3.0)]. Conclusion: An insufficient number of patients were interested in participating in the trial. Efforts to enhance motivation of PWH with at-risk alcohol use to engage in alcohol-related research and build upon ISAT are needed.

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“…Besides, it has been reported that alcohol use is associated with an increase in the risk of chronic illnesses such as cardiovascular disease and cancer in people living with HIV [18][19][20][21][22]. Alcohol use among people living with HIV affects negatively on their adherence and engagement to the HIV treatment, treatment outcomes and mortality risk [7,[23][24][25]. There are various pharmacological/behavioral treatments for treating AUDs [26][27][28][29][30][31].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of naltrexone treatment for alcohol use disorders in HIV: a systematic review

Farhadian

Moradi

Zamanian

et al. 2020

Subst Abuse Treat Prev Policy

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Background: Because alcohol use disorders (AUDs) in patients living with HIV/AIDS are associated with a reduction in therapeutic outcomes and increases the risk of morbidity/mortality, finding an appropriate pharmacotherapy treatment for this disorder is necessary. Objectives: This systematic review contains studies that examine the effects of pharmacological intervention (oral naltrexone (NTX) or injectable extended-release naltrexone (XR-NTX)) on the persons living with HIV and AUDs. Methods: A systematic literature search using three electronic databases including Pubmed Medline, Scopus and the Cochrane Library and Google Scholar was conducted and includes articles published from 1995 to 2019. Records were collected by searching relevant keywords and those that meet the inclusion/exclusion criteria are included. Results: Overall, in this systematic review, the results of 7 relevant studies including pilot and randomized controlled/ clinical trials were summarized and reviewed. Among selected records 2 of these assessed the efficacy of NTX and 5 tested the XR-NTX effectiveness in treating AUDs among persons living with HIV (PLH). In summary, with some expectations, NTX and XR-NTX administration in persons living with HIV and AUDs led to reduced alcohol use, improved viral suppression, unchanged ART adherence and has no significant adverse events. Conclusion: The findings of this systematic review suggest the beneficial effects and safety of the NTX and XR-NTX for treating AUDs in PLH. Further studies are needed in the future to focus on the treatment of AUDs in people living with HIV.

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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

Cited by 78 publications

References 61 publications

Comprehensive Assessment of Alcohol Consumption in People Living with HIV (PLWH): The New Orleans Alcohol Use in HIV Study

Comprehensive Assessment of Alcohol Consumption in People Living with HIV (PLWH): The New Orleans Alcohol Use in HIV Study

Integrated stepped alcohol treatment for patients with HIV and at-risk alcohol use: a randomized trial

Effectiveness of naltrexone treatment for alcohol use disorders in HIV: a systematic review

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