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Alcohol Use and Antiretroviral Adherence Among Patients Living with HIV: Is Change in Alcohol Use Associated with Change in Adherence?
AIDS Behav. 2020 Jul 02 [Online ahead of print]AB

Abstract

Alcohol use increases non-adherence to antiretroviral therapy (ART) among persons living with HIV (PLWH). Dynamic longitudinal associations are understudied. Veterans Aging Cohort Study (VACS) data 2/1/2008-7/31/16 were used to fit linear regression models estimating changes in adherence (% days with ART medication fill) associated with changes in alcohol use based on annual clinically-ascertained AUDIT-C screening scores (range - 12 to + 12, 0 = no change) adjusting for demographics and initial adherence. Among 21,275 PLWH (67,330 observations), most reported no (48%) or low-level (39%) alcohol use initially, with no (55%) or small (39% ≤ 3 points) annual change. Mean initial adherence was 86% (SD 21%), mean annual change was - 3.1% (SD 21%). An inverted V-shaped association was observed: both increases and decreases in AUDIT-C were associated with greater adherence decreases relative to stable scores [p < 0.001, F (4, 21,274)]. PLWH with dynamic alcohol use (potentially indicative of alcohol use disorder) should be considered for adherence interventions.

Authors+Show Affiliations

Health Services Research & Development (HSR&D), Center of Innovation for Veteran-Centered Value-Driven Care, Veteran Affairs (VA) Puget Sound Health Care System, 1660 S. Columbian Way, S-152, Seattle, WA, 98108, USA. emily.williams3@va.gov. Department of Health Services, University of Washington, Seattle, WA, USA. emily.williams3@va.gov.Veterans Aging Cohort Study Coordinating Center, VA Connecticut Healthcare System, West Haven, CT, USA.Health Services Research & Development (HSR&D), Center of Innovation for Veteran-Centered Value-Driven Care, Veteran Affairs (VA) Puget Sound Health Care System, 1660 S. Columbian Way, S-152, Seattle, WA, 98108, USA. Kidney Health Research Collaborative, University of California, San Francisco and VA San Francisco Health Care System, San Francisco, CA, USA.Health Services Research & Development (HSR&D), Center of Innovation for Veteran-Centered Value-Driven Care, Veteran Affairs (VA) Puget Sound Health Care System, 1660 S. Columbian Way, S-152, Seattle, WA, 98108, USA. Department of Health Services, University of Washington, Seattle, WA, USA. Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.Health Services Research & Development (HSR&D), Center of Innovation for Veteran-Centered Value-Driven Care, Veteran Affairs (VA) Puget Sound Health Care System, 1660 S. Columbian Way, S-152, Seattle, WA, 98108, USA. Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.Schools of Medicine and Public Health, Yale University, New Haven, CT, USA.Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.Betty Irene Moore School of Nursing, University of California at Davis, Sacramento, CA, USA.Department of Health Services, University of Washington, Seattle, WA, USA. Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.National Institute On Alcohol Abuse and Alcoholism, Bethesda, MD, USA.Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.Health Services Research, Rutgers University, New Brunswick, NJ, USA.Division of Epidemiology, Department of Internal Medicine, Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), University of Utah School of Medicine, Salt Lake City, UT, USA. Informatics, Decision-Enhancement, and Analytic Sciences Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA.Veterans Aging Cohort Study Coordinating Center, VA Connecticut Healthcare System, West Haven, CT, USA.Veterans Aging Cohort Study Coordinating Center, VA Connecticut Healthcare System, West Haven, CT, USA. Schools of Medicine and Public Health, Yale University, New Haven, CT, USA.Veterans Aging Cohort Study Coordinating Center, VA Connecticut Healthcare System, West Haven, CT, USA. Schools of Medicine and Public Health, Yale University, New Haven, CT, USA.Health Services Research & Development (HSR&D), Center of Innovation for Veteran-Centered Value-Driven Care, Veteran Affairs (VA) Puget Sound Health Care System, 1660 S. Columbian Way, S-152, Seattle, WA, 98108, USA. Department of Health Services, University of Washington, Seattle, WA, USA. Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA. Center of Excellence in Substance Abuse Treatment and Education (CESATE) VA Puget Sound Healthcare System-Seattle Division, Seattle, WA, USA. Department of Medicine, University of Washington, Seattle, WA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32617778

Citation

Williams, Emily C., et al. "Alcohol Use and Antiretroviral Adherence Among Patients Living With HIV: Is Change in Alcohol Use Associated With Change in Adherence?" AIDS and Behavior, 2020.
Williams EC, McGinnis KA, Rubinsky AD, et al. Alcohol Use and Antiretroviral Adherence Among Patients Living with HIV: Is Change in Alcohol Use Associated with Change in Adherence? AIDS Behav. 2020.
Williams, E. C., McGinnis, K. A., Rubinsky, A. D., Matson, T. E., Bobb, J. F., Lapham, G. T., Edelman, E. J., Satre, D. D., Catz, S. L., Richards, J. E., Bryant, K. J., Marshall, B. D. L., Kraemer, K. L., Crystal, S., Gordon, A. J., Skanderson, M., Fiellin, D. A., Justice, A. C., & Bradley, K. A. (2020). Alcohol Use and Antiretroviral Adherence Among Patients Living with HIV: Is Change in Alcohol Use Associated with Change in Adherence? AIDS and Behavior. https://doi.org/10.1007/s10461-020-02950-x
Williams EC, et al. Alcohol Use and Antiretroviral Adherence Among Patients Living With HIV: Is Change in Alcohol Use Associated With Change in Adherence. AIDS Behav. 2020 Jul 2; PubMed PMID: 32617778.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alcohol Use and Antiretroviral Adherence Among Patients Living with HIV: Is Change in Alcohol Use Associated with Change in Adherence? AU - Williams,Emily C, AU - McGinnis,Kathleen A, AU - Rubinsky,Anna D, AU - Matson,Theresa E, AU - Bobb,Jennifer F, AU - Lapham,Gwen T, AU - Edelman,E Jennifer, AU - Satre,Derek D, AU - Catz,Sheryl L, AU - Richards,Julie E, AU - Bryant,Kendall J, AU - Marshall,Brandon D L, AU - Kraemer,Kevin L, AU - Crystal,Stephen, AU - Gordon,Adam J, AU - Skanderson,Melissa, AU - Fiellin,David A, AU - Justice,Amy C, AU - Bradley,Katharine A, Y1 - 2020/07/02/ PY - 2020/7/4/entrez KW - ART KW - Adherence KW - Alcohol use KW - Antiretroviral therapy KW - HIV JF - AIDS and behavior JO - AIDS Behav N2 - Alcohol use increases non-adherence to antiretroviral therapy (ART) among persons living with HIV (PLWH). Dynamic longitudinal associations are understudied. Veterans Aging Cohort Study (VACS) data 2/1/2008-7/31/16 were used to fit linear regression models estimating changes in adherence (% days with ART medication fill) associated with changes in alcohol use based on annual clinically-ascertained AUDIT-C screening scores (range - 12 to + 12, 0 = no change) adjusting for demographics and initial adherence. Among 21,275 PLWH (67,330 observations), most reported no (48%) or low-level (39%) alcohol use initially, with no (55%) or small (39% ≤ 3 points) annual change. Mean initial adherence was 86% (SD 21%), mean annual change was - 3.1% (SD 21%). An inverted V-shaped association was observed: both increases and decreases in AUDIT-C were associated with greater adherence decreases relative to stable scores [p < 0.001, F (4, 21,274)]. PLWH with dynamic alcohol use (potentially indicative of alcohol use disorder) should be considered for adherence interventions. SN - 1573-3254 UR - https://www.unboundmedicine.com/medline/citation/32617778/Alcohol_Use_and_Antiretroviral_Adherence_Among_Patients_Living_with_HIV:_Is_Change_in_Alcohol_Use_Associated_with_Change_in_Adherence L2 - https://doi.org/10.1007/s10461-020-02950-x DB - PRIME DP - Unbound Medicine ER -
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