TY - JOUR
T1 - Heavy alcohol use is associated with worse retention in HIV care
AU - Monroe, Anne K.
AU - Lau, Bryan
AU - Mugavero, Michael J.
AU - Mathews, William C.
AU - Mayer, Kenneth H.
AU - Napravnik, Sonia
AU - Hutton, Heidi E.
AU - Kim, Hongseok S.
AU - Jabour, Sarah
AU - Moore, Richard D.
AU - McCaul, Mary E.
AU - Christopoulos, Katerina A.
AU - Crane, Heidi C.
AU - Chander, Geetanjali
N1 - Funding Information:
Supported by National Institutes of Mental Health (K 23MH105284 to A.K.M.); Alcohol Research Consortium in HIV-Administrative Core (to M.E.M.); National Institute of Alcohol Abuse and Alcoholism/National Institutes of Health: U24AA020801; Alcohol Research Consortium in HIV Epidemiological Research Arm; National Institutes of Health/National Institute of Alcohol Abuse and Alcoholism: U01AA020793 (Kitahata, PI); P30-AI094189 (Hopkins Center for AIDS Research; Chaisson, PI); R24 AI067039 (UAB Center for AIDS Research Network of Integrated Clinical Systems; Saag, PI).
Publisher Copyright:
© 2016 Wolters Kluwer Health, Inc.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Background: Poor retention in HIV care is associated with worse clinical outcomes and increased HIV transmission. We examined the relationship between self-reported alcohol use, a potentially modifiable behavior, and retention. Methods: A total of 9694 people living with HIV from 7 participating US HIV clinical sites (the Centers for AIDS Research Network of Integrated Clinical Systems) contributed 23,225 observations from January 2011 to June 2014. The retention outcomes were (1) Institute of Medicine (IOM) retention: 2 visits within 1 year at least 90 days apart and (2) visit adherence [proportion of kept visits/(scheduled + kept visits)]. Alcohol use was measured with Alcohol Use Disorders Identification Test-C, generating drinking (never, moderate, and heavy) and binge frequency (never, monthly/less than monthly, weekly/daily) categories. Adjusted multivariable logistic models, accounting for repeat measures, were generated. Results: Of our sample, 82% was men, 46% white, 35% black, and 14% Hispanic. At first assessment, 37% of participants reported never drinking, 38% moderate, and 25% heavy, and 89% of the patients were retained (IOM retention measure). Participants' mean (SD) visit adherence was 84% (25%). Heavy alcohol use was associated with inferior IOM-defined retention (adjusted odds ratio 0.78, 95% confidence interval: 0.69 to 0.88), and daily/weekly binge drinking was associated with lower visit adherence (adjusted odds ratio 0.90, 95% confidence interval: 0.82 to 0.98). Conclusions: Both heavy drinking and frequent binge drinking were associated with worse retention in HIV care. Increased identification and treatment of heavy and binge drinking in HIV clinical care settings may improve retention in HIV care, with downstream effects of improved clinical outcomes and decreased HIV transmission.
AB - Background: Poor retention in HIV care is associated with worse clinical outcomes and increased HIV transmission. We examined the relationship between self-reported alcohol use, a potentially modifiable behavior, and retention. Methods: A total of 9694 people living with HIV from 7 participating US HIV clinical sites (the Centers for AIDS Research Network of Integrated Clinical Systems) contributed 23,225 observations from January 2011 to June 2014. The retention outcomes were (1) Institute of Medicine (IOM) retention: 2 visits within 1 year at least 90 days apart and (2) visit adherence [proportion of kept visits/(scheduled + kept visits)]. Alcohol use was measured with Alcohol Use Disorders Identification Test-C, generating drinking (never, moderate, and heavy) and binge frequency (never, monthly/less than monthly, weekly/daily) categories. Adjusted multivariable logistic models, accounting for repeat measures, were generated. Results: Of our sample, 82% was men, 46% white, 35% black, and 14% Hispanic. At first assessment, 37% of participants reported never drinking, 38% moderate, and 25% heavy, and 89% of the patients were retained (IOM retention measure). Participants' mean (SD) visit adherence was 84% (25%). Heavy alcohol use was associated with inferior IOM-defined retention (adjusted odds ratio 0.78, 95% confidence interval: 0.69 to 0.88), and daily/weekly binge drinking was associated with lower visit adherence (adjusted odds ratio 0.90, 95% confidence interval: 0.82 to 0.98). Conclusions: Both heavy drinking and frequent binge drinking were associated with worse retention in HIV care. Increased identification and treatment of heavy and binge drinking in HIV clinical care settings may improve retention in HIV care, with downstream effects of improved clinical outcomes and decreased HIV transmission.
KW - HIV clinical care
KW - adherence
KW - alcohol use
KW - retention
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U2 - 10.1097/QAI.0000000000001083
DO - 10.1097/QAI.0000000000001083
M3 - Article
C2 - 27243904
AN - SCOPUS:84973099668
SN - 1525-4135
VL - 73
SP - 419
EP - 425
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 4
ER -