The Role of Alcohol-Related Behavioral Research in the Design of HIV Secondary Prevention Interventions in the Era of Antiretroviral Therapy: Targeted Research Priorities Moving Forward

Shuper, Paul A.

doi:10.1007/s10461-021-03302-z

Cited by 5 publications

(8 citation statements)

References 164 publications

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“…HIV preventionand treatment-related outcomes can be improved by addressing alcohol use through behavioral [90], pharmacological [91], and policy/structural-level interventions [92,93]. Tailoring and targeting these interventions to meet the unique needs of diverse populations affected by HIV may further enhance their effectiveness and help reduce the global HIV burden [94].…”

Section: Addressing the Intersection Of Alcohol Use And Hivmentioning

confidence: 99%

“…Interventions in other settings, such as bars and communities, may also be ideal and feasible (e.g., [194][195][196]) but have yielded mixed results [194,195]. Secondary prevention, which entails TasP (discussed below), with high adherence to ART to bring about viral suppression, is particularly important yet problematic in people living with HIV who drink alcohol [94].…”

Section: Reducing the Incidence Of Communicable Diseasesmentioning

confidence: 99%

“…Since alcohol use complicates the treatment of many communicable diseases, integration of alcohol use reduction counseling or screening and brief interventions into TB [197], HIV [94], or pneumonia [150] treatment services has been recommended. Similarly, screening for TB [197] or HIV among people with AUDs has also been recommended, as has the co-location of services [94]. However, the evidence base regarding the effectiveness of such approaches for all communicable disease categories of interest in the current report is fairly limited.…”

Section: Improving Treatment Outcomesmentioning

confidence: 99%

“…Efforts to improve treatment outcomes and improve secondary prevention for people living with HIV who drink alcohol require emphasizing linkage and retention in care, ART initiation, ART adherence, viral suppression, and condom use [94]. A recently published high-quality systematic review and meta-analysis involving 21 studies and 8461 people living with HIV, 69% of whom were on ART, has indicated (contrary to other findings, [200][201][202]) that individual-level behavioral interventions were effective in reducing the quantity and heavy consumption (but not alcohol use or alcohol use frequency), increasing condom use (but not affecting the number of sexual partners or a composite index of sexual risk), reducing viral load, and increasing ART adherence [90].…”

Section: Improving Treatment Outcomesmentioning

confidence: 99%

“…Interventions in which participants were recruited from clinics were most likely to be effective. As supplements to such interventions, additional approaches that have been recommended include the use of technology to deliver interventions, use of ultra-brief interventions, prevention of increased alcohol consumption or the development of AUDs, a focus on aging populations, addressing psychosocial comorbidities, and improving accessibility and convenience of HIV care [94]. Occasionally, health workers have stigmatizing attitudes or inadequate knowledge that can lead to inadvertent ART nonadherence among their patients [203].…”

Section: Improving Treatment Outcomesmentioning

confidence: 99%

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Alcohol Use and the Risk of Communicable Diseases

et al. 2021

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The body of knowledge on alcohol use and communicable diseases has been growing in recent years. Using a narrative review approach, this paper discusses alcohol’s role in the acquisition of and treatment outcomes from four different communicable diseases: these include three conditions included in comparative risk assessments to date—Human Immunodeficiency Virus (HIV)/AIDS, tuberculosis (TB), and lower respiratory infections/pneumonia—as well as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) because of its recent and rapid ascension as a global health concern. Alcohol-attributable TB, HIV, and pneumonia combined were responsible for approximately 360,000 deaths and 13 million disability-adjusted life years lost (DALYs) in 2016, with alcohol-attributable TB deaths and DALYs predominating. There is strong evidence that alcohol is associated with increased incidence of and poorer treatment outcomes from HIV, TB, and pneumonia, via both behavioral and biological mechanisms. Preliminary studies suggest that heavy drinkers and those with alcohol use disorders are at increased risk of COVID-19 infection and severe illness. Aside from HIV research, limited research exists that can guide interventions for addressing alcohol-attributable TB and pneumonia or COVID-19. Implementation of effective individual-level interventions and alcohol control policies as a means of reducing the burden of communicable diseases is recommended.

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