Role of Alcohol and Substances of Abuse in the Immunomodulation of Human Immunodeficiency Virus Disease

Goforth, Harold W.; Lupash, Daniel P; Brown, Martha E.; Tan, Jun; Fernandez, F

doi:10.1097/01.adt.0000137432.11895.ee

Cited by 6 publications

(1 citation statement)

References 37 publications

(35 reference statements)

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“…In a meta-analysis, subjects using alcohol were twice as likely to report poor adherence to ART as compared with abstainers (Hendershot et al, 2009). Alcohol consumption can affect immunologic function (Goforth et al, 2004) and cause early death (Neblett et al, 2011). Among those on ART, alcohol use has been associated with lower CD4 cell counts and higher HIV viral loads (Baum et al, 2010;Hendershot et al, 2009;Samet et al, 2003); impaired memory, concentration, and physical movements (Nevid et al, 2006); negative encounters with healthcare providers (Kagee & Delport, 2010); and reinforcement of poor health behaviors (Ware et al, 2006).…”

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confidence: 99%

The Role of Alcohol on Antiretroviral Therapy Adherence Among Persons Living With HIV in Urban India

Schensul

et al. 2017

J. Stud. Alcohol Drugs

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The purpose of this study was to estimate the prevalence of alcohol use among men living with HIV on antiretroviral therapy (ART) and examine the association of alcohol use and psychosocial variables on ART adherence. The study was a cross-sectional survey supplemented by medical records and qualitative narratives as a part of the initial formative stage of a multilevel, multicentric intervention and evaluation project. Method: A screening instrument was administered to men living with HIV (n = 3,088) at four ART Centers using the Alcohol Use Disorders Identifi cation Test-consumption questions (AUDIT-C) to determine alcohol use for study eligibility. Alcohol screening data were triangulated with medical records of men living with HIV (n = 15,747) from 13 ART Centers to estimate alcohol consumption among men on ART in greater Mumbai. A survey instrument to identify associations between ART adherence and alcohol, psychosocial, and contextual factors was administered to eligible men living with HIV (n = 361), and in-depth interviews (n = 55) were conducted to elucidate the ways in which these factors are manifest in men's lives. Results: Nearly one fi fth of men living with HIV on ART in the Mumbai area have consumed alcohol in the last 30 days. Non-adherence was associated with a higher AUDIT score, consumption of more types of alcohol, and poorer self-ratings on quality of life, depression, and external stigma. The qualitative data demonstrate that non-adherence results from avoiding the mixing of alcohol with medication, forgetfulness when drinking, and skipping medication for fear of disclosure of HIV status when drinking with friends. Conclusions: As the demand for ART expands, Indian government programs will need to more effectively address alcohol to reduce risk and maintain effective adherence.

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confidence: 99%

The Role of Alcohol on Antiretroviral Therapy Adherence Among Persons Living With HIV in Urban India

Schensul

et al. 2017

J. Stud. Alcohol Drugs

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Mental Health

and¹,

Lee²

2010

Nutrition and HIV

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Identifying the Intersection of Alcohol, Adherence and Sex in HIV Positive Men on ART Treatment in India Using an Adapted Timeline Followback Procedure

Schensul

et al. 2017

AIDS Behav

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Objective(s) People Living with HIV (PLHIV) on anti-retroviral treatment (ART) who drink are less adherent and more likely to engage in unprotected sex. Using an adapted Timeline Follow-Back (A-TLFB) procedure, this paper examines the day by day interface of alcohol, medication adherence and sex to provide a fine grained understanding of how multiple behavioral risks coincide in time and space, explores concordance/discordance of measures with survey data and identifies potential recall bias. Methods Data are drawn from a survey of behavior, knowledge and attitudes, and a 30 day TLFB assessment of multiple risk behaviors adapted for the Indian PLHIV context, administered to 940 alcohol-consuming, HIV positive men on ART at the baseline evaluation stage of a multilevel, multi-centric intervention study Results On days participants drank they were significantly more likely to be medication non-adherent and to have unprotected sex. In the first day after their alcohol consuming day, the pattern of nonadherence persisted. Binge and regular drinking days were associated with nonadherence but only binge drinking co-occurred with unprotected sex. Asking about specific “drinking days” improved recall for drinking days and number of drinks consumed. Recall declined for drinking days and nonadherence from the first week to subsequent weeks but varied randomly for sex risk. There was high concordance and low discordance between adapted TLFB drinking and nonadherence but these results were reversed for unprotected sex. Conclusions Moving beyond simple drinking-adherence correlational analysis, the adapted TLFB offers improved recall probes and provides researchers and interventionists with the opportunity to identify types of risky days and tailor behavioral modification to reduce alcohol consumption, nonadherence and risky sex on those days.

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Role of Alcohol and Substances of Abuse in the Immunomodulation of Human Immunodeficiency Virus Disease

Cited by 6 publications

References 37 publications

The Role of Alcohol on Antiretroviral Therapy Adherence Among Persons Living With HIV in Urban India

The Role of Alcohol on Antiretroviral Therapy Adherence Among Persons Living With HIV in Urban India

Mental Health

Identifying the Intersection of Alcohol, Adherence and Sex in HIV Positive Men on ART Treatment in India Using an Adapted Timeline Followback Procedure

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