The Impact of Alcohol Use on Antiretroviral Therapy Adherence in Koreans Living with HIV

Abstract

This study aimed to examine the impact of alcohol use on the antiretroviral therapy (ART) adherence of Koreans living with human immunodeficiency virus (HIV). Methods: A total of 144 HIV-infected Koreans older than the age of 19 years who had been receiving antiretroviral drugs for at least 3 months were surveyed. Alcohol use was identified as nonhazardous, binge, hazardous, and alcohol dependent as determined by the Alchol Use Disorder Identification Test-Korea (AUDIT-K). ART adherence was defined according to the components of adherence motivation, adherence knowledge, and 95% medication adherence using the modified Morisky scale. Collected data were analyzed using logistic regression analysis for each component of therapy adherence. Results: Of all participants, 13.9% were binge drinkers, 17.4% were hazardous drinkers, and 4.2% were alcohol dependent. For low adherence motivation, the odds ratio for the hazardous drinkers was 7.47 [95% confidence interval (CI): 1.72-32.41; p ¼ .007] and for the alcohol dependent, it was 12.61 (95% CI: 1.38-115.38; p ¼ .025) when compared with the nonhazardous drinkers. For medication adherence under 95%, the odds ratio for binge drinkers was 4.65 (95% CI: 1.15-18.92; p ¼ .032), for hazardous drinkers was 8.05 (95% CI: 2.08-31.20; p ¼ .003), and for the alcohol dependent was 27.67 (95% CI: 2.12-360.51; p ¼ .011). Conclusion: It is recommended that Korean institutions and governments develop specific mediation and counseling programs that include alcohol useerelated monitoring for the improvement of the ART adherence of people living with HIV.

Prevalence and Risks of Depression and Substance Use Among Adults Living with HIV in the Asia–Pacific Region

“…Our finding that those with suboptimal adherence in the previous year were more likely to experience moderate-to-severe depressive symptoms and report moderate-to-high risk substance use adds to the substantial body of evidence from this region linking mental health issues, substance use and poorer adherence across different adult PLHIV populations [ 20 , 32 , 39 – 43 ]. Our finding that mean CD4 cell count and viral load < 1000 copies/mL were not risk factors for moderate-to-high risk substance use or moderate-to-severe depressive symptoms, adds to the insubstantial and conflicting regional evidence of associations between mental health or substance use and HIV clinical or treatment outcomes.…”

Virological Non-Suppression, Non-Adherence and the Associated Factors Among People Living with HIV on Dolutegravir-Based Regimens: A Retrospective Cohort Study

“…These factors were comparable to those found in previous studies. Alcohol use [46][47][48][49][50] may reduce adherence because alcohol consumption lowers the concentration and reasoning capacity of the consumer, causing them to miss doses, especially on drinking days. 46 Stigma was another reason, as identified in previous studies; [51][52][53] this because it causes a diminished desire to take medication, self-rejection, and depression, leading to poor adherence.…”

An update on drug–drug interactions between antiretroviral therapies and drugs of abuse in HIV systems

“…Individuals with alcohol use disorder are unable to control their alcohol use which can result in unhealthy consequences [17].Alcohol use disorders are common among PLWHA [18]. Recent studies conducted in different countries showed that the prevalence of alcohol use disorder among PLWHA ranges from 14.0% to 38.4% [18][19][20][21][22][23][24][25][26], which was 3-times higher than the general population (5.8%−11.1%) [17] [27]. A recent meta-analysis that analyzed a total of 25 studies with more than 25,000 participants from 2010 to 2019 showed that the pooled estimated prevalence of alcohol use disorder among PLWHA was 29.8% [18].…”

“…Recent clinical studies conducted from different countries also showed the impact of alcohol use on adherence to ART [23,26] [30,31] [30]. For example, a study in Korea showed the increase in alcohol consumption was related to a decrease in adherence to ART [26]. The ratio of patients with less than 95% ART adherence for binge drinkers, hazardous drinkers, and alcohol dependents were 4.65%, 8.05%, and 27.67%, respectively.…”