Systematic Review: Effect of Alcohol Intake on Adherence to Outpatient Medication Regimens for Chronic Diseases

Grodensky, Catherine A.; Golin, Carol E.; Ochtera, Rebecca D.; Turner, Barbara J.

doi:10.15288/jsad.2012.73.899

Cited by 71 publications

(60 citation statements)

References 80 publications

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“…Moreover, AUDs differ from alcohol use per se in that AUDs are medically defined conditions that are amenable to intervention [54]. AUDs have previously been associated with decreased ART adherence in other settings and populations [55,56] and to other poor HIV-treatment outcomes, including decreased health care utilization [57], decreased linkage to and retention in care [58,59], reduced ART medication access [60,61] and viral non-suppression [58]. In Peru's largest biobehavioral serosurveillance study of over 5000 Peruvian MSM, AUDs were previously found to be highly prevalent (62.3%) and independently associated with high-risk sexual behaviors [26-28] and being unaware of being HIV-infected [29].…”

Section: Discussionmentioning

confidence: 99%

Alcohol use disorders negatively influence antiretroviral medication adherence among men who have sex with men in Peru

et al. 2014

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Objective-As international guidelines increase access to antiretroviral therapy (ART) globally, ART adherence becomes increasingly important to achieve HIV treatment as prevention (TasP) goals. In the concentrated HIV epidemic among men who have sex with men (MSM) and transgendered women (TGW) in Lima, Peru, the independent correlates of ART non-adherence were examined to inform treatment intervention priorities.Design-Cross sectional survey of HIV-infected MSM and TGW who are engaged in clinical care in Lima, Peru. Methods-FromJune to August 2012, 302 HIV-infected Peruvian MSM/TGW from three clinical care sites were recruited using convenience sampling to participate in a cross-sectional computer-assisted adherence survey. Several standardized screening measures associated with ART non-adherence were examined in order to determine the independent correlates of optimal (≥90%) and perfect (100%) adherence, which were assessed using logistic regression.Results-Of the 302 participants recruited, 263 (87.1%) were prescribed ART. Among those prescribed ART, 229 (87.1%) reported optimal and 146 (55.5%) reported perfect adherence. The prevalence of alcohol use disorders (AUD; 43.2%), alcohol dependence (5.3%), recent drug use (6.0%) and depression (44.5%) was high and most participants had some evidence of neurocognitive impairment. Meeting criteria for having an AUD and depression were collinear (p<0.001). On multivariate analysis, having an AUD was inversely related and the only Conclusions-AUDs are highly prevalent among Peruvian HIV-infected MSM and contribute significantly to ART non-adherence. These findings support the need for screening and treating underlying AUDs. In order to meet HIV TasP goals, evidence-based strategies targeting AUDs are likely to directly improve ART adherence and indirectly improve overall individual health, HIV treatment engagement and reduce transmission to sexual partners among this vulnerable and disproportionally affected population.

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Section: Discussionmentioning

confidence: 99%

Alcohol use disorders negatively influence antiretroviral medication adherence among men who have sex with men in Peru

et al. 2014

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“…Alcohol and other drug use have been linked to poor adherence to antiretroviral therapy (ART), (Azar, Springer, Meyer, & Altice, 2010; Grodensky, Golin, Ochtera, & Turner, 2012; Jaquet et al, 2010; Van geertruyden, Woelk, Mukumbi, Ryder, & Colebunders, 2010) more rapid HIV disease progression (Baum et al, 2010; Samet et al, 2007) and poorer HIV treatment outcomes among people living with HIV/AIDS (PLWHA) (Azar et al, 2010). The success of ART in reducing HIV incidence in serodiscordant couples (Cohen et al, 2011) generated hope that HIV epidemics could be controlled and reversed through the use of HIV treatment as prevention (Branson, Viall, & Marum, 2013; Granich, Williams, & Montaner, 2013).…”

Section: Introductionmentioning

confidence: 99%

Alcohol and drug use outcomes among vulnerable women living with HIV: results from the Western Cape Women's Health CoOp

et al. 2014

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Alcohol and other drug use can negatively affect adherence to and retention in antiretroviral therapy (ART) among people living with HIV. Yet, there are few brief interventions that reduce these behaviors among this population. This article presents the findings from a randomized field experiment that assessed the effects of a woman-focused intervention (the Women’s Health CoOp [WHC]) on reducing alcohol and other drug use among vulnerable women in Cape Town, South Africa. The analyses were limited to 84 women living with HIV who reported drinking alcohol at baseline. Because of the small sample size, analyses were performed using an exact logistic regression procedure. At 12-month follow-up, women in the WHC arm were more likely to be abstinent from alcohol (Odds Ratio [OR] = 3.61; 95% Confidence Intervals [CI] = 1.23, 11.70; p = 0.016) and somewhat more likely to test negative for other drugs (OR = 3.07; 95% CI = 0.83,12.31; p = 0.105), compared with women in the comparison arms. This study provides preliminary evidence of the efficacy of a brief, woman-focused intervention in reducing alcohol and other drug use among vulnerable women living with HIV and it has implications for HIV treatment.

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“…Although episodic heavy drinking represents a clear risk to the health of an individual, even moderate levels of alcohol consumption may present behavioral risks to HIV-infected patients (Grodensky et al, 2012), such as unprotected sexual behavior (Shuper et al, 2009), especially for those who tend to consume alcohol in contexts related to sexual activity (Fisher et al, 2007, 2010). However, information about what constitutes a “safe” level of drinking for an HIV-infected patient remains to be specified and is likely determined by important patient individual differences (e.g., CD4 count, behavioral risks, treatment adherence).…”

Section: Discussionmentioning

confidence: 99%

“…Heavy drinking has been linked with HIV disease progression through both biological and behavioral mechanisms (Pandrea et al, 2010; Samet et al, 2007). Although there is no clear level of “safe” drinking among those who are HIV-infected, alcohol consumption at even moderate doses has been shown to increase behavioral risks for HIV progression (Grodensky et al, 2012; Fisher et al, 2007; Shuper et al, 2009). …”

Section: Introductionmentioning

confidence: 99%

“…Heavy drinking is defined by National Institute for Alcohol Abuse and Alcoholism (NIAAA) guidelines of ≥14 total drinks per week or single occasion drinking of ≥5 drinks for men and ≥7 drinks per week or single occasion drinking of ≥4 drinks for women. Although they appear to be associated with different patterns of risk behaviors among HIV patients, both heavy episodic drinking and quantity of alcohol consumption are associated with important HIV outcomes (Grodensky et al, 2012; Shuper et al, 2009). We hypothesized that those with more severe depressive symptoms on the BDI-II would consume more drinks per day and exhibit more frequent heavy drinking episodes.…”

Section: Introductionmentioning

confidence: 99%

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The influence of depressive symptoms on alcohol use among HIV-infected Russian drinkers

Palfai¹,

Cheng²,

Coleman³

et al. 2014

Drug and Alcohol Dependence

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Background Depressive symptoms have been linked to HIV progression through a number of biobehavioral mechanisms including increased alcohol use. Although research supports an association between alcohol use and depressive symptoms among HIV patients, there have been few studies that have examined whether depressive symptoms predict subsequent drinking, especially among heavy drinking HIV-infected patients. Method Heavy drinking Russian HIV-infected patients (n = 700) were recruited from addiction and HIV care settings for a randomized controlled trial of a risk reduction intervention [HERMITAGE]. GEE overdispersed Poisson regression analyses were conducted to assess the association between depressive symptoms and alcohol consumption 6-months later. Results In adjusted analyses, depressive symptom severity was significantly associated with drinks per day (global p = .02). Compared to the non-depressed category, mild depressive symptoms were significantly associated with more drinks per day [IRR = 1.55, (95% CI: 1.14, 2.09)], while moderate [IRR = 1.14, (95% CI: 0.83, 1.56)] and severe [IRR = 1.48, (95% CI: 0.93, 2.34)] depressive symptoms were not. Associations between depressive symptom severity and heavy drinking days were not statistically significant (global p = .19). Secondary analyses using the BDI-II screening threshold (BDI-II > 14) and the BDI-II cognitive subscale suggested an association between depressive symptoms and drinks per day over time but not heavy episodic drinking. Conclusions Among heavy drinking HIV-infected patients, elevated depressive symptoms were associated with greater subsequent alcohol use. These findings suggest that depressive symptoms may be important to address in efforts to reduce alcohol-related risks among HIV-infected populations.

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Systematic Review: Effect of Alcohol Intake on Adherence to Outpatient Medication Regimens for Chronic Diseases

Cited by 71 publications

References 80 publications

Alcohol use disorders negatively influence antiretroviral medication adherence among men who have sex with men in Peru

Alcohol use disorders negatively influence antiretroviral medication adherence among men who have sex with men in Peru

Alcohol and drug use outcomes among vulnerable women living with HIV: results from the Western Cape Women's Health CoOp

The influence of depressive symptoms on alcohol use among HIV-infected Russian drinkers

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