title: The Association Between Changes in Alcohol Use and Changes in Antiretroviral Therapy Adherence and Viral Suppression Among Women Living with HIV.
abstract: Heavy alcohol use has adverse effects in women with HIV. We examined the association between changes in alcohol use (measured with Timeline Followback) and changes in antiretroviral therapy adherence (medication possession ratio) and viral suppression (HIV RNA), measured over 6-month intervals. Among women who were (1) non-adherent or not virologically suppressed and (2) infrequent binge drinkers or non-heavy drinkers at baseline, increasing drinking was significantly associated with lower odds of subsequently improving adherence or viral suppression (OR of becoming adherent of 0.90 in infrequent binge drinkers; OR of becoming suppressed of 0.81 and 0.75 in infrequent binge drinkers and non-heavy drinkers, respectively). Our findings suggest that for these women, increasing drinking may be a barrier to achieving viral suppression. Addressing this barrier by integrating proactive alcohol counseling strategies into routine HIV care may be key to improving viral suppression rates among women retained in HIV care.
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street #8060, Baltimore, MD, 21287, USA.
authors.forename: Nikita
authors.initials: N
authors.lastname: Barai
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street #8060, Baltimore, MD, 21287, USA. amonroe4@jhmi.edu.|Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. amonroe4@jhmi.edu.
authors.forename: Anne
authors.identifier: http://orcid.org/0000-0003-3201-3845
authors.initials: A
authors.lastname: Monroe
authors.affiliation: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Lesko
authors.affiliation: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Bryan
authors.initials: B
authors.lastname: Lau
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Heidi
authors.initials: H
authors.lastname: Hutton
authors.affiliation: Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA.
authors.forename: Cui
authors.initials: C
authors.lastname: Yang
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street #8060, Baltimore, MD, 21287, USA.
authors.forename: Anika
authors.initials: A
authors.lastname: Alvanzo
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Mary Elizabeth
authors.initials: ME
authors.lastname: McCaul
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street #8060, Baltimore, MD, 21287, USA.|Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Geetanjali
authors.initials: G
authors.lastname: Chander
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology*; D000435:Alcoholic Intoxication / Q000150:complications; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D063425:Binge Drinking / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D055118:Medication Adherence; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012044:Regression Analysis; D014481:United States / Q000453:epidemiology; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral
keywords: Alcohol; Antiretroviral medication adherence; HIV infection; Viral load; Women