Changes in Days of Unhealthy Alcohol Use and Antiretroviral Therapy Adherence, HIV RNA Levels, and Condomless Sex: A Secondary Analysis of Clinical Trial Data

AIDS Behav. 2020 Jun;24(6):1784-1792. doi: 10.1007/s10461-019-02742-y.

Abstract

In a sample of people with HIV (PWH) enrolled in an alcohol intervention trial and followed for 12 months, we examined the association of changes in days (i.e., decrease, increase, no change [reference]) of unhealthy drinking (consuming ≥ 4/≥ 5 drinks for women/men) with antiretroviral therapy adherence (≥ 95% adherent), viral suppression (HIV RNA < 75 copies/mL), condomless sex with HIV-negative/unknown status partners, and dual-risk outcome (HIV RNA ≥ 75 copies/mL plus condomless sex). The sample included 566 PWH (96.8% male; 63.1% White; 93.9% HIV RNA < 75 copies/mL) who completed baseline, 6-, and 12-month assessments. Decrease in days of unhealthy drinking was associated with increased likelihood of viral suppression (odds ratio [OR] 3.78; 95% confidence interval [CI] 1.06, 13.51, P = .04) versus no change. Increase in days of unhealthy drinking was associated with increased likelihood of condomless sex (OR 3.13; 95% CI 1.60, 6.12, P < .001). Neither increase nor decrease were associated with adherence or dual-risk outcome. On a continuous scale, for each increase by 1 day of unhealthy drinking in the prior month, the odds of being 95% adherent decreased by 6% (OR 0.94, 95% CI 0.88, 1.00, P = 0.04).

Keywords: Alcohol; Antiretroviral therapy adherence; HIV transmission risk; Primary care; Viral control.

MeSH terms

  • Adult
  • Alcohol Drinking / adverse effects*
  • Alcohol Drinking / epidemiology
  • Anti-Retroviral Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active*
  • Clinical Trials as Topic
  • Condoms
  • Female
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • HIV Infections / psychology
  • HIV Infections / virology
  • Humans
  • Longitudinal Studies
  • Male
  • Medication Adherence*
  • RNA, Viral / blood
  • Sexual Partners
  • Unsafe Sex / statistics & numerical data*
  • Viral Load

Substances

  • Anti-Retroviral Agents
  • RNA, Viral