Not all non-drinkers with HIV are equal: demographic and clinical comparisons among current non-drinkers with and without a history of prior alcohol use disorders

AIDS Care. 2017 Feb;29(2):177-184. doi: 10.1080/09540121.2016.1204418. Epub 2016 Aug 2.


Studies of persons living with HIV (PLWH) have compared current non-drinkers to at-risk drinkers without differentiating whether current non-drinkers had a prior alcohol use disorder (AUD). The purpose of this study was to compare current non-drinkers with and without a prior AUD on demographic and clinical characteristics to understand the impact of combining them. We included data from six sites across the US from 1/2013 to 3/2015. Patients completed tablet-based clinical assessments at routine clinic appointments using the most recent assessment. Current non-drinkers were identified by AUDIT-C scores of 0. We identified a prior probable AUD by a prior AUD diagnosis in the electronic medical record (EMR) or a report of attendance at alcohol treatment in the clinical assessment. We used multivariate logistic regression to examine factors associated with prior AUD. Among 2235 PLWH who were current non-drinkers, 36% had a prior AUD with more patients with an AUD identified by the clinical assessment than the EMR. Higher proportions with a prior AUD were male, depressed, and reported current drug use compared to non-drinkers without a prior AUD. Former cocaine/crack (70% vs. 25%), methamphetamine/crystal (49% vs. 16%), and opioid/heroin use (35% vs. 7%) were more commonly reported by those with a prior AUD. In adjusted analyses, male sex, past methamphetamine/crystal use, past marijuana use, past opioid/heroin use, past and current cocaine/crack use, and cigarette use were associated with a prior AUD. In conclusion, this study found that among non-drinking PLWH in routine clinical care, 36% had a prior AUD. We found key differences between those with and without prior AUD in demographic and clinical characteristics, including drug use and depression. These results suggest that non-drinkers are heterogeneous and need further differentiation in studies and that prior alcohol misuse (including alcohol treatment) should be included in behavioural health assessments as part of clinical care.

Keywords: HIV; adherence; alcohol use; alcohol use disorders; substance use.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Alcohol Drinking / epidemiology*
  • Alcohol-Related Disorders / diagnosis
  • Alcohol-Related Disorders / epidemiology*
  • Amphetamine-Related Disorders / epidemiology
  • Cocaine-Related Disorders / epidemiology
  • Demography
  • Electronic Health Records
  • Female
  • HIV Infections / epidemiology*
  • Humans
  • Longitudinal Studies
  • Male
  • Marijuana Abuse / epidemiology
  • Middle Aged
  • Opioid-Related Disorders / epidemiology
  • Sex Factors
  • Surveys and Questionnaires