Lauren Lipira1, Deepa Rao2, Paul E Nevin3, Christopher G Kemp4, Susan E Cohn5, Janet M Turan6, Jane M Simoni7, Michele P Andrasik8, Audrey L French9, Joseph M Unger10, Patrick Heagerty11, Emily C Williams12. 1. Department of Health Services, University of Washington, 1959 NE Pacific St, Magnuson Health Sciences Center, Room H-680, Seattle, WA, 98195-7660, United States; Department of Global Health, University of Washington, Harris Hydraulics Laboratory, Box 357965, Seattle, WA, 98195-7965, United States. Electronic address: lauren.e.lipira@dhsoha.state.or.us. 2. Department of Global Health, University of Washington, Harris Hydraulics Laboratory, Box 357965, Seattle, WA, 98195-7965, United States; Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Box 356560, Room BB1644, Seattle, WA, 98195-6560, United States. Electronic address: deeparao@uw.edu. 3. Department of Global Health, University of Washington, Harris Hydraulics Laboratory, Box 357965, Seattle, WA, 98195-7965, United States. Electronic address: penevin@uw.edu. 4. Department of Global Health, University of Washington, Harris Hydraulics Laboratory, Box 357965, Seattle, WA, 98195-7965, United States. Electronic address: kempc@uw.edu. 5. Department of Medicine, Northwestern University Feinberg School of Medicine, 645 North Michigan Avenue, Suite 926, Chicago, IL, 60611, United States. Electronic address: susan-cohn@northwestern.edu. 6. Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Ryals Public Health Building (RPHB), 1665 University Boulevard, Birmingham, AL, 35294-0022, United States. Electronic address: jmturan@uab.edu. 7. Department of Psychology, University of Washington, 119A Guthrie Hall, Box 351525, Seattle, WA, 98195-1525, United States. Electronic address: jsimoni@uw.edu. 8. Vaccine and Infectious Disease Division, Fred Hutch, 1100 Fairview Ave N., Mail Stop E5-110, Seattle, WA, 98109, United States. Electronic address: mandrasik@fredhutch.org. 9. Stroger Hospital of Cook County, Ruth M. Rothstein CORE Center, 2020 W. Harrison St, Chicago, IL, 60612, United States. Electronic address: afrench@cookcountyhhs.org. 10. Department of Health Services, University of Washington, 1959 NE Pacific St, Magnuson Health Sciences Center, Room H-680, Seattle, WA, 98195-7660, United States; Public Health Sciences Division, Fred Hutch. 1100 Fairview Ave N., Mail Stop M3-C102, Seattle, WA, 98109, United States. Electronic address: junger@fredhutch.org. 11. Department of Biostatistics, University of Washington, Box 357232, Seattle, WA, 98195-7232, United States. Electronic address: heagerty@uw.edu. 12. Department of Health Services, University of Washington, 1959 NE Pacific St, Magnuson Health Sciences Center, Room H-680, Seattle, WA, 98195-7660, United States; Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System Health Services Research & Development, 1660 S. Columbian Way (S-152), Seattle, WA, 98108, United States. Electronic address: Emily.Williams3@va.gov.
Abstract
BACKGROUND: Alcohol use is common among people living with HIV and negatively impacts care and outcomes. African-American women living with HIV are subject to vulnerabilities that may increase risk for alcohol use and associated HIV-related outcomes. METHODS: We used baseline data from a randomized controlled trial of an HIV-related stigma-reduction intervention among African-American women living with HIV in Chicago and Birmingham (2013-2015). Patterns of alcohol use [any use, unhealthy alcohol use (UAU), heavy episodic drinking (HED)] were measured using the AUDIT-C. We assessed demographic, social, and clinical characteristics which may influence alcohol use and HIV-related outcomes which may be influenced by patterns of alcohol use in bivariate and multivariable analyses. RESULTS: Among 220 African-American women living with HIV, 54 % reported any alcohol use, 24 % reported UAU, and 27 % reported HED. In bivariate analysis, greater depressive symptoms, lower religiosity, lower social support, marijuana, and crack/cocaine use were associated with patterns of alcohol use (p < 0.05). Marijuana and cocaine/crack use were associated with patterns of alcohol use in adjusted analysis (p < 0.05). In adjusted analysis, any alcohol use and HED were associated with lower likelihood of ART adherence (ARR = 0.72, 95 % CI: 0.53-0.97 and ARR = 0.65, 95 % CI: 0.44-0.96, respectively), and UAU was associated with lack of viral suppression (ARR = 0.78, 95 % CI: 0.63-0.96). CONCLUSIONS: Findings suggest any and unhealthy alcohol use is common and associated with poor HIV-related outcomes in this population. Regular alcohol screening and intervention should be offered, potentially targeted to subgroups (e.g., those with other substance use).
RCT Entities:
BACKGROUND:Alcohol use is common among people living with HIV and negatively impacts care and outcomes. African-American women living with HIV are subject to vulnerabilities that may increase risk for alcohol use and associated HIV-related outcomes. METHODS: We used baseline data from a randomized controlled trial of an HIV-related stigma-reduction intervention among African-American women living with HIV in Chicago and Birmingham (2013-2015). Patterns of alcohol use [any use, unhealthy alcohol use (UAU), heavy episodic drinking (HED)] were measured using the AUDIT-C. We assessed demographic, social, and clinical characteristics which may influence alcohol use and HIV-related outcomes which may be influenced by patterns of alcohol use in bivariate and multivariable analyses. RESULTS: Among 220 African-American women living with HIV, 54 % reported any alcohol use, 24 % reported UAU, and 27 % reported HED. In bivariate analysis, greater depressive symptoms, lower religiosity, lower social support, marijuana, and crack/cocaine use were associated with patterns of alcohol use (p < 0.05). Marijuana and cocaine/crack use were associated with patterns of alcohol use in adjusted analysis (p < 0.05). In adjusted analysis, any alcohol use and HED were associated with lower likelihood of ART adherence (ARR = 0.72, 95 % CI: 0.53-0.97 and ARR = 0.65, 95 % CI: 0.44-0.96, respectively), and UAU was associated with lack of viral suppression (ARR = 0.78, 95 % CI: 0.63-0.96). CONCLUSIONS: Findings suggest any and unhealthy alcohol use is common and associated with poor HIV-related outcomes in this population. Regular alcohol screening and intervention should be offered, potentially targeted to subgroups (e.g., those with other substance use).
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