Patterns of alcohol use and associated characteristics and HIV-related outcomes among a sample of African-American women living with HIV. (1st January 2020)

• Record Type: Journal Article
• Authors: Lipira, Lauren; Rao, Deepa; Nevin, Paul E.; Kemp, Christopher G.; Cohn, Susan E.; Turan, Janet M.; Simoni, Jane M.; Andrasik, Michele P.; French, Audrey L.; Unger, Joseph M.; Heagerty, Patrick; Williams, Emily C.
• Is Part Of: Drug and alcohol dependence. Volume 206(2020)
• Publication Date: 2020-01-01
• Subjects: African-American women -- Alcohol use -- Depression -- Religiosity -- Substance use; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2019.107753
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Over half of African-American women living with HIV reported any alcohol use. A quarter reported both unhealthy alcohol use and heavy episodic drinking. Religiosity and social support were associated with less alcohol use. Depression and other substance use were associated with greater alcohol use. Any and unhealthy alcohol use were associated with poor HIV-related outcomes. 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).