BACKGROUND: Alcohol use is frequently implicated as a factor in nonadherence to highly active antiretroviral therapy (HAART). There have not been efforts to systematically evaluate findings across studies. This meta-analysis provides a quantitative evaluation of the alcohol-adherence association by aggregating findings across studies and examining potential moderators. METHODS: Literature searches identified 40 qualifying studies totaling over 25,000 participants. Studies were coded on several methodological variables. RESULTS: In the combined analysis, alcohol drinkers were approximately 50%-60% as likely to be classified as adherent [odds ratio (OR) = 0.548, 95% confidence interval (CI): 0.490 to 0.612] compared with abstainers (or those who drank relatively less). Effect sizes for problem drinking, defined as meeting the National Institute on Alcohol Abuse and Alcoholism criteria for at-risk drinking or criteria for an alcohol use disorder, were greater (OR = 0.474, 95% CI = 0.408 to 0.550) than those reflecting any or global drinking (OR = 0.604, 95% CI = 0.531 to 0.687). Several variables moderated the alcohol-adherence association. CONCLUSIONS: Results support a significant and reliable association of alcohol use and medication nonadherence. Methodological variables seem to moderate this association and could contribute to inconsistent findings across studies. Future research would benefit from efforts to characterize theoretical mechanisms and mediators and moderators of the alcohol-adherence association.
BACKGROUND:Alcohol use is frequently implicated as a factor in nonadherence to highly active antiretroviral therapy (HAART). There have not been efforts to systematically evaluate findings across studies. This meta-analysis provides a quantitative evaluation of the alcohol-adherence association by aggregating findings across studies and examining potential moderators. METHODS: Literature searches identified 40 qualifying studies totaling over 25,000 participants. Studies were coded on several methodological variables. RESULTS: In the combined analysis, alcohol drinkers were approximately 50%-60% as likely to be classified as adherent [odds ratio (OR) = 0.548, 95% confidence interval (CI): 0.490 to 0.612] compared with abstainers (or those who drank relatively less). Effect sizes for problem drinking, defined as meeting the National Institute on Alcohol Abuse and Alcoholism criteria for at-risk drinking or criteria for an alcohol use disorder, were greater (OR = 0.474, 95% CI = 0.408 to 0.550) than those reflecting any or global drinking (OR = 0.604, 95% CI = 0.531 to 0.687). Several variables moderated the alcohol-adherence association. CONCLUSIONS: Results support a significant and reliable association of alcohol use and medication nonadherence. Methodological variables seem to moderate this association and could contribute to inconsistent findings across studies. Future research would benefit from efforts to characterize theoretical mechanisms and mediators and moderators of the alcohol-adherence association.
Authors: L F Brigido; R Rodrigues; J Casseb; D Oliveira; M Rossetti; P Menezes; A J Duarte Journal: AIDS Patient Care STDS Date: 2001-11 Impact factor: 5.078
Authors: C A Kleeberger; J P Phair; S A Strathdee; R Detels; L Kingsley; L P Jacobson Journal: J Acquir Immune Defic Syndr Date: 2001-01-01 Impact factor: 3.731
Authors: Alexander C Tsai; Dan H Karasic; Gwendolyn P Hammer; Edwin D Charlebois; Kathy Ragland; Andrew R Moss; James L Sorensen; James W Dilley; David R Bangsberg Journal: Am J Public Health Date: 2012-06-21 Impact factor: 9.308
Authors: Christopher W Kahler; David W Pantalone; Nadine R Mastroleo; Tao Liu; Gerald Bove; Bharat Ramratnam; Peter M Monti; Kenneth H Mayer Journal: J Consult Clin Psychol Date: 2018-08
Authors: Judith A Hahn; Nneka I Emenyonu; Robin Fatch; Winnie R Muyindike; Allen Kekiibina; Adam W Carrico; Sarah Woolf-King; Stephen Shiboski Journal: Addiction Date: 2015-11-05 Impact factor: 6.526
Authors: Nikita Barai; Anne Monroe; Catherine Lesko; Bryan Lau; Heidi Hutton; Cui Yang; Anika Alvanzo; Mary Elizabeth McCaul; Geetanjali Chander Journal: AIDS Behav Date: 2017-07
Authors: Kathleen A McGinnis; Janet P Tate; Emily C Williams; Melissa Skanderson; Kendall J Bryant; Adam J Gordon; Kevin L Kraemer; Stephen A Maisto; Steven Crystal; David A Fiellin; Amy C Justice Journal: Drug Alcohol Depend Date: 2016-09-22 Impact factor: 4.492
Authors: Emily C Williams; Judith A Hahn; Richard Saitz; Kendall Bryant; Marlene C Lira; Jeffrey H Samet Journal: Alcohol Clin Exp Res Date: 2016-09-22 Impact factor: 3.455