Comprehensive Assessment of Alcohol Consumption in People Living with HIV (PLWH): The New Orleans Alcohol Use in HIV Study

Abstract Aim This cross-sectional analysis of the New Orleans Alcohol Use in HIV (NOAH) study assesses whether current and lifetime alcohol use in people living with HIV (PLWH) are associated with greater liver disease and how hepatitis C-viral (HCV) co-infection (HIV/HCV+) modifies the association. Methods Alcohol use was measured by Lifetime Drinking History (LDH), a 30-day Timeline Followback calendar, the Alcohol Use Disorder Identification Test, and phosphatidylethanol. Liver disease was estimated by alanine aminotransferase (ALT), aspartate aminotransferase (AST), AST platelet ratio-index (APRI), fibrosis-4 index (FIB-4) and nonalcoholic fatty liver disease-fibrosis score. Associations between alcohol consumption and liver disease were estimated with multivariable logistic regression. Models were adjusted for age, sex, body-mass index, hepatitis B and HIV viral load. Results Participants (N = 353) were majority male (69%) and black (84%) with a mean age of 48.3 ± 10 years. LDH was significantly associated with advanced liver fibrosis (FIB-4 aOR = 22.22 [1.22–403.72]) only among HIV/HCV+ participants with an LDH of 100–600 kg. HIV/HCV+ participants had a higher prevalence of intermediate and advanced liver disease markers than HIV/HCV− (P < 0.0001). Advanced markers of liver disease were most strongly associated with hazardous drinking (≥40(women)/60(men) grams/day) (APRI aOR = 15.87 (3.22–78.12); FIB-4 aOR = 6.76 (1.81–7.16)) and PEth ≥400 ng/ml (APRI aOR = 17.52 (2.55–120.54); FIB-4 aOR = 17.75 (3.30–95.630). Conclusion Results indicate a greater association of current alcohol use with liver disease than lifetime alcohol use, which varied by HCV status. These findings stress the importance of reducing alcohol use in PLWH to decrease risk of liver disease and fibrosis.

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Advancing Behavioral HIV Prevention: Adapting an Evidence-Based Intervention for People Living with HIV and Alcohol Use Disorders

AIDS Research and Treatment ◽

10.1155/2015/879052 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 3

Author(s):

M. L. Armstrong ◽

A. M. LaPlante ◽

F. L. Altice ◽

M. Copenhaver ◽

P. E. Molina

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Hiv Prevention ◽

Disease Progression ◽

Alcohol Use Disorders ◽

People Living With Hiv ◽

Evidence Based ◽

Care Clinic ◽

Heavy Alcohol ◽

Living With Hiv

Alcohol use disorders (AUDs) are highly prevalent among people living with HIV/AIDS (PLWHA) and are associated with increased HIV risk behaviors, suboptimal treatment adherence, and greater risk for disease progression. We used the ADAPT-ITT strategy to adapt an evidence-based intervention (EBI), the Holistic Health Recovery Program (HHRP+), that focuses on secondary HIV prevention and antiretroviral therapy (ART) adherence and apply it to PLWHA with problematic drinking. Focus groups (FGs) were conducted with PLWHA who consume alcohol and with treatment providers at the largest HIV primary care clinic in New Orleans, LA. Overall themes that emerged from the FGs included the following: (1) negative mood states contribute to heavy alcohol consumption in PLWHA; (2) high levels of psychosocial stress, paired with few adaptive coping strategies, perpetuate the use of harmful alcohol consumption in PLWHA; (3) local cultural norms are related to the permissiveness and pervasiveness of drinking and contribute to heavy alcohol use; (4) healthcare providers unanimously stated that outpatient options for AUD intervention are scarce, (5) misperceptions about the relationships between alcohol and HIV are common; (6) PLWHA are interested in learning about alcohol’s impact on ART and HIV disease progression. These data were used to design the adapted EBI.

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Cultural Adaptation of an Intervention to Reduce Hazardous Alcohol Use Among People Living with HIV in Southwestern Uganda

AIDS and Behavior ◽

10.1007/s10461-021-03186-z ◽

2021 ◽

Author(s):

Anna M. Leddy ◽

Judith A. Hahn ◽

Monica Getahun ◽

Nneka I. Emenyonu ◽

Sarah E. Woolf-King ◽

...

Keyword(s):

Alcohol Use ◽

Cultural Adaptation ◽

People Living With Hiv ◽

Hazardous Alcohol Use ◽

Hazardous Alcohol ◽

Living With Hiv ◽

Southwestern Uganda

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Negative Consequences of Alcohol Use among People Living with HIV

Substance Use & Misuse ◽

10.1080/10826084.2021.1899232 ◽

2021 ◽

pp. 1-8

Author(s):

Rebecca J. Fisk ◽

Veronica L. Richards ◽

Robert F. Leeman ◽

Babette Brumback ◽

Christa Cook ◽

...

Keyword(s):

Alcohol Use ◽

People Living With Hiv ◽

Negative Consequences ◽

Living With Hiv

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Depression, suicidality, and alcohol use disorder among people living with HIV/AIDS in Nigeria

BMC Public Health ◽

10.1186/s12889-017-4467-5 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 25

Author(s):

Catherine O. Egbe ◽

Patrick S. Dakum ◽

Ernest Ekong ◽

Brandon A. Kohrt ◽

John G. Minto ◽

...

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

People Living With Hiv ◽

Living With Hiv ◽

Hiv Aids

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Unique Circulating MicroRNA Associations with Dysglycemia in People Living with HIV and Alcohol Use

Physiological Genomics ◽

10.1152/physiolgenomics.00085.2021 ◽

2021 ◽

Author(s):

Brianna L Bourgeois ◽

Hui-Yi Lin ◽

Alice Y Yeh ◽

Danielle E. Levitt ◽

Stefany DePrato Primeaux ◽

...

Keyword(s):

Alcohol Use ◽

Tolerance Test ◽

Oral Glucose ◽

Circulating Microrna ◽

People Living With Hiv ◽

Regression Analyses ◽

Circulating Micrornas ◽

Altered Glucose ◽

Function Correlation ◽

Living With Hiv

People living with HIV (PLWH) have increased prevalence of comorbid conditions including insulin resistance and at-risk alcohol use. Circulating microRNAs (miRs) may serve as minimally invasive indicators of pathophysiological states. We aimed to identify whether alcohol modulates circulating miR associations with measures of glucose/insulin dynamics in PLWH. PLWH (N=96; 69.8% male) enrolled in the Alcohol & Metabolic Comorbidities in PLWH: Evidence-Driven Interventions (ALIVE-Ex) study were stratified into negative phosphatidylethanol (PEth<8ng/ml, N=42) and positive PEth (PEth≥8ng/ml, N=54) groups. An oral glucose tolerance test (OGTT) was administered, and total RNA was isolated from fasting plasma to determine absolute miR expression. Circulating miRs were selected based on their role in skeletal muscle (miR-133a, miR-206), pancreatic β-cell (miR-375), liver (miR-20a), and adipose tissue (miR-let-7b, miR-146a, miR-221) function. Correlation and multiple regression analyses between miR expression and adiponectin, 2h glucose, insulin, and C-peptide values were performed adjusting for BMI category, age, sex, and viral load. miR-133a was negatively associated with adiponectin (p=0.002) in the negative PEth group, and miR-20a was positively associated with 2h glucose (p=0.013) in the positive PEth group. Regression analyses combining miRs demonstrated that miR-133a (p<0.001) and miR-221 (p=0.010) together predicted adiponectin in the negative PEth group. miR-20a (p<0.001) and miR-375 (p=0.002) together predicted 2h glucose in the positive PEth group. Our results indicate that associations between miRs and measures of glucose/insulin dynamics differed between PEth groups suggesting that the pathophysiological mechanisms contributing to altered glucose homeostasis in PLWH are potentially modulated by alcohol use.

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‘What will it take’: addressing alcohol use among people living with HIV in South Africa

International Journal of STD & AIDS ◽

10.1177/0956462419862899 ◽

2019 ◽

Vol 30 (11) ◽

pp. 1049-1054 ◽

Cited By ~ 3

Author(s):

K Sorsdahl ◽

NK Morojele ◽

CD Parry ◽

CT Kekwaletswe ◽

N Kitleli ◽

...

Keyword(s):

South Africa ◽

Alcohol Use ◽

Brief Intervention ◽

Hiv Treatment ◽

Hiv And Aids ◽

Hiv Care ◽

People Living With Hiv ◽

Screening And Brief Intervention ◽

Treatment Services ◽

Living With Hiv

Given that hazardous and harmful alcohol use has been identified as a significant barrier to adherence to antiretroviral therapy (ART) in South Africa, alcohol reduction interventions delivered within HIV treatment services are being investigated. Prior to designing and implementing an alcohol-focused screening and brief intervention (SBI), we explored patients’ perceptions of alcohol as a barrier to HIV treatment, the acceptability of providing SBIs for alcohol use within the context of HIV services and identifying potential barriers to patient uptake of this SBI. Four focus groups were conducted with 23 participants recruited from three HIV treatment sites in Tshwane, South Africa. Specific themes that emerged included: (1) barriers to ART adherence, (2) available services to address problematic alcohol use and (3) barriers and facilitators to delivering a brief intervention to address alcohol use within HIV care. Although all participants in the present study unanimously agreed that there was a great need for SBIs to address alcohol use among people living with HIV and AIDS, our study identified several areas that should be considered prior to implementing such a programme.

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