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Interventions to Reduce Alcohol Use among HIV-Infected Individuals: A Review and Critique of the Literature

  • Behavioral Aspects of HIV Management (RJ DiClemente and JL Brown, Section Editors)
  • Published:
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Abstract

Alcohol use disorders are common among HIV-infected individuals and are associated with adverse physiological complications and increased engagement in other health risk behaviors. This paper provides a review and critique of interventions to reduce alcohol use among HIV-infected individuals, including a: (a) synthesis of core intervention components and trial designs; (b) summary of intervention efficacy to reduce alcohol use outcomes; and (c) methodological critique and guidance for future research. We reviewed 14 behavioral interventions that reported on alcohol use outcomes among HIV-infected individuals. Findings were mixed for intervention efficacy to reduce alcohol frequency and quantity. There was limited evidence that interventions reduced binge drinking frequency or alcohol abuse or dependence symptoms. Despite the prevalence of disordered alcohol use among HIV-infected individuals, there is lack of efficacious intervention approaches. Efficacious intervention approaches to reduce alcohol use among HIV-infected individuals are urgently needed.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. CDC: Estimated HIV incidence among adults and adolescents in the United States, 2007–2010. HIV Surveillance Supplemental Report. 2012, 17.

  2. WHO: Global HIV/AIDS Response: Epidemic update and health sector progress towards universal access. 2011.

  3. CDC: HIV Surveillance Report, 2011. 2013, 23.

  4. Klinkenberg WD, Sacks S. Mental disorders and drug abuse in persons living with HIV/AIDS. AIDS Care. 2004;16:S22–42.

    Article  PubMed  Google Scholar 

  5. Pence BW, Miller WC, Whetten K, Eron JJ, Gaynes BN. Prevalence of DSM-IV-defined mood, anxiety, and substance use disorders in an HIV clinic in the Southeastern United States. J Acquir Immune Defic Syndr. 2006;42:298–306.

    Article  PubMed  Google Scholar 

  6. Galvan FH, Bing EG, Fleishman JA, et al. The prevalence of alcohol consumption and heavy drinking among people with HIV in the United States: results from the HIV Cost and Services Utilization Study. J Stud Alcohol. 2002;63:179–86.

    PubMed  Google Scholar 

  7. Chander G, Lau B, Moore RD. Hazardous alcohol use: a risk factor for non-adherence and lack of suppression in HIV infection. J Acquir Immune Defic Syndr. 2006;43:411–7.

    Article  PubMed  Google Scholar 

  8. Michel L, Carrieri MP, Fugon L, et al. Harmful alcohol consumption and patterns of substance use in HIV-infected patients receiving antiretrovirals (ANRS-EN12-VESPA Study): relevance for clinical management and intervention. AIDS Care. 2010;22:1136–45.

    Article  PubMed  Google Scholar 

  9. Sullivan LE, Goulet JL, Justice AC, Fiellin DA. Alcohol consumption and depressive symptoms over time: a longitudinal study of patients with and without HIV infection. Drug Alcohol Depend. 2011;117:158–63.

    Article  PubMed  CAS  Google Scholar 

  10. Persidsky Y, Ho W, Ramirez SH, et al. HIV-1 infection and alcohol abuse: neurocognitive impairment, mechanisms of neurodegeneration and therapeutic interventions. Brain Behav Immun. 2011;25:S61–70.

    Article  PubMed  Google Scholar 

  11. Weber E, Morgan EE, Iudicello JE, et al. Substance use is a risk factor for neurocognitive deficits and neuropsychiatric distress in acute and early HIV infection. J Neurovirol. 2013;19:65–74.

    Article  PubMed  CAS  Google Scholar 

  12. Neuman MG, Monteiro M, Rehm J. Drug interactions between psychoactive substances and antiretroviral therapy in individuals infected with human immunodeficiency and hepatitis viruses. Subst Use Misuse. 2006;41:1395–463.

    Article  PubMed  Google Scholar 

  13. Barve S, Kapoor R, Moghe A, et al. Focus on the liver: alcohol use, highly active antiretroviral therapy, and liver disease in HIV-infected patients. Alcohol Res Health. 2010;33:229–36.

    PubMed  Google Scholar 

  14. Braithwaite RS, Bryant KJ. Influence of alcohol consumption on adherence to and toxicity of antiretroviral therapy and survival. Alcohol Res Health. 2010;33:280–7.

    PubMed  Google Scholar 

  15. Salmon-Ceron D, Lewden C, Morlat P, et al. Liver disease as a major cause of death among HIV infected patients: role of hepatitis C and B viruses and alcohol. J Hepatol. 2005;42:799–805.

    Article  PubMed  CAS  Google Scholar 

  16. Matthews GV, Rockstroh J. HIV and hepatitis C coinfection. Curr Opin HIV AIDS. 2011;6:449–50.

    Article  PubMed  Google Scholar 

  17. Ferrari LF, Levine JD. Alcohol consumption enhances antiretroviral painful peripheral neuropathy by mitochondrial mechanisms. Eur J Neurosci. 2010;32:811–8.

    Article  PubMed  Google Scholar 

  18. Braithwaite RS, McGinnis KA, Conigliaro J, et al. A temporal and dose–response association between alcohol consumption and medication adherence among veterans in care. Alcohol Clin Exp Res. 2005;29:1190–7.

    Article  PubMed  Google Scholar 

  19. Grierson J, Koelmeyer RL, Smith A, Pitts M. Adherence to antiretroviral therapy: factors independently associated with reported difficulty taking antiretroviral therapy in a national sample of HIV-positive Australians. HIV Med. 2011;12:562–9.

    Article  PubMed  CAS  Google Scholar 

  20. Carrieri MP, Spire B, Lert F, Michel L. Time to combine intervention with prevention in countries where HIV is also driven by hazardous drinking. Addiction. 2013;108:221–2.

    Article  PubMed  Google Scholar 

  21. Hendershot CS, Stoner SA, Pantalone DW, Simoni JM. Alcohol use and antiretroviral adherence: review and meta-analysis. J Acquir Immune Defic Syndr. 2009;52:180–202.

    Article  PubMed  Google Scholar 

  22. Samet JH, Horton NJ, Meli S, Freedberg KA, Palepu A. Alcohol consumption and antiretroviral adherence among HIV-infected persons with alcohol problems. Alcohol Clin Exp Res. 2004;28:572–7.

    Article  PubMed  CAS  Google Scholar 

  23. Balfour L, Kowal J, Silverman A, et al. A randomized controlled psycho-education intervention trial: improving psychological readiness for successful HIV medication adherence and reducing depression before initiating HAART. AIDS Care. 2006;18:830–8.

    Article  PubMed  CAS  Google Scholar 

  24. Paterson DL, Swindells S, Mohr J, et al. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133:21–30.

    Article  PubMed  CAS  Google Scholar 

  25. Clavel F, Hance AJ. HIV drug resistance. New Engl J Med. 2004;350:1023–35.

    PubMed  CAS  Google Scholar 

  26. Simoni JM, Montgomery A, Martin E, et al. Adherence to antiretroviral therapy for pediatric HIV infection: a qualitative systematic review with recommendations for research and clinical management. Pediatrics. 2007;119:e1371–83.

    Article  PubMed  Google Scholar 

  27. Moore DM, Zhang W, Yip B, et al. Non-medically supervised treatment interruptions among participants in a universally accessible antiretroviral therapy programme. HIV Med. 2010;11:299–307.

    Article  PubMed  CAS  Google Scholar 

  28. Yuan Y, L’Italien G, Mukherjee J, Iloeje UH. Determinants of discontinuation of initial highly active antiretroviral therapy regimens in a US HIV-infected patient cohort. HIV Med. 2006;7:156–62.

    Article  PubMed  CAS  Google Scholar 

  29. • Azar MM, Springer SA, Meyer JP, Altice FL. A systematic review of the impact of alcohol use disorders on HIV treatment outcomes, adherence to antiretroviral therapy and health care utilization. Drug Alcohol Depend. 2010;112:178–93. This paper provides a review of the effects of alcohol use disorders among HIV-infected individuals on antiretroviral medication adherence, health care utilization, and biological endpoints.

    Article  PubMed  Google Scholar 

  30. Samet JH, Cheng DM, Libman H, et al. Alcohol consumption and HIV disease progression. JAIDS: J Acquir Immune Defic Syndr. 2007;46:194–9.

    Article  PubMed  Google Scholar 

  31. Cunningham WE, Sohler NL, Tobias C, et al. Health services utilization for people with HIV infection: comparison of a population targeted for outreach with the U.S. population in care. Med Care. 2006;44:1038–47.

    Article  PubMed  Google Scholar 

  32. Kim TW, Kertesz SG, Horton NJ, Tibbetts N, Samet JH. Episodic homelessness and health care utilization in a prospective cohort of HIV-infected persons with alcohol problems. BMC Health Serv Res. 2006;6:19.

    Article  PubMed  Google Scholar 

  33. Gordon AJ, McGinnis KA, Conigliaro J, et al. Associations between alcohol use and homelessness with healthcare utilization among human immunodeficiency virus-infected veterans. Med Care. 2006;44:S37–43.

    Article  PubMed  Google Scholar 

  34. Theall KP, Amedee A, Clark RA, Dumestre J, Kissinger P. Alcohol consumption and HIV-1 vaginal RNA shedding among women. J Stud Alcohol Drugs. 2008;69:454–8.

    PubMed  Google Scholar 

  35. Homans J, Christensen S, Stiller T, et al. Permissive and protective factors associated with presence, level, and longitudinal pattern of cervicovaginal HIV shedding. J Acquir Immune Defic Syndr. 2012;60:99–110.

    Article  PubMed  Google Scholar 

  36. Stein M, Herman DS, Trisvan E, et al. Alcohol use and sexual risk behavior among human immunodeficiency virus-positive persons. Alcohol Clin Exp Res. 2005;29:837–43.

    Article  PubMed  Google Scholar 

  37. Hasse B, Ledergerber B, Hirschel B, et al. Frequency and determinants of unprotected sex among HIV-infected persons: the Swiss HIV cohort study. Clin Infect Dis. 2010;51:1314–22.

    Article  PubMed  Google Scholar 

  38. Dirks H, Esser S, Borgmann R, et al. Substance use and sexual risk behaviour among HIV-positive men who have sex with men in specialized out-patient clinics. HIV Med. 2012;13:533–40.

    PubMed  CAS  Google Scholar 

  39. Theall KP, Clark RA, Powell A, Smith H, Kissinger P. Alcohol consumption, ART usage and high-risk sex among women infected with HIV. AIDS Behav. 2007;11:205–15.

    Article  PubMed  CAS  Google Scholar 

  40. Saggurti N, Raj A, Mahapatra B, et al. Prevalence and correlates of non-disclosure of HIV serostatus to sex partners among HIV-infected female sex workers and HIV-infected male clients of female sex workers in India. AIDS Behav. 2013;17:399–406.

    Article  PubMed  Google Scholar 

  41. •• Samet JH, Walley AY. Interventions targeting HIV-infected risky drinkers: drops in the bottle. Alcohol Res Health. 2010;33:267–79. This paper conducted a review of studies with HIV-infected individuals with past or current unhealthy alcohol use and studies with samples comprised of 10% or more currently using alcohol.

    PubMed  Google Scholar 

  42. Aharonovich E, Hatzenbuehler ML, Johnston B, et al. A low-cost, sustainable intervention for drinking reduction in the HIV primary care setting. AIDS Care. 2006;18:561–8.

    Article  PubMed  CAS  Google Scholar 

  43. Murphy DA, Chen X, Naar-King S, Parsons JT. Alcohol and marijuana use outcomes in the healthy choices motivational interviewing intervention for HIV-positive youth. AIDS Patient Care STDs. 2012;26:95–100.

    Article  PubMed  Google Scholar 

  44. Parsons JT, Golub SA, Rosof E, Holder C. Motivational interviewing and cognitive-behavioral intervention to improve HIV medication adherence among hazardous drinkers: a randomized controlled trial. J Acquir Immune Defic Syndr. 2007;46:443–50.

    Article  PubMed  Google Scholar 

  45. Velasquez MM, von Sternberg K, Johnson DH, et al. Reducing sexual risk behaviors and alcohol use among HIV-positive men who have sex with men: a randomized clinical trial. J Consult Clin Psychol. 2009;77:657–67.

    Article  PubMed  Google Scholar 

  46. Gilbert P, Ciccarone D, Gansky SA, et al. Interactive “Video Doctor” counseling reduces drug and sexual risk behaviors among HIV-positive patients in diverse outpatient settings. Plos One. 2008;3:e1988.

    Article  PubMed  Google Scholar 

  47. Naar-King S, Wright K, Parsons JT, et al. Healthy choices: motivational enhancement therapy for health risk behaviors in HIV-positive youth. AIDS Care. 2006;18:1–11.

    Google Scholar 

  48. Naar-King S, Lam P, Wang B, et al. Brief report: maintenance of effects of motivational enhancement therapy to improve risk behaviors and HIV-related Health in a randomized controlled trial of youth living with HIV. J Pediatr Psychol. 2008;33:441–5.

    Article  PubMed  Google Scholar 

  49. Samet JH, Horton NJ, Meli S, et al. A randomized controlled trial to enhance antiretroviral therapy adherence in patients with a history of alcohol problems. Antivir Ther. 2005;10:83–93.

    PubMed  CAS  Google Scholar 

  50. Meade CS, Drabkin AS, Hansen NB, et al. Reductions in alcohol and cocaine use following a group coping intervention for HIV-positive adults with childhood sexual abuse histories. Addiction. 2010;105:1942–51.

    Article  PubMed  Google Scholar 

  51. Papas RK, Sidle JE, Gakinya BN, et al. Treatment outcomes of a stage 1 cognitive-behavioral trial to reduce alcohol use among human immunodeficiency virus-infected out-patients in western Kenya. Addiction. 2011;106:2156–66.

    Article  PubMed  Google Scholar 

  52. Jones DL, Weiss SM, Chitalu N, et al. Sexual risk intervention in multiethnic drug and alcohol users. Am J Infect Dis. 2007;3:169–76.

    Article  PubMed  Google Scholar 

  53. Wong FL, Rotheram-Borus MJ, Lightfoot M, et al. Effects of behavioral intervention on substance use among people living with HIV: the Healthy Living Project randomized controlled study. Addiction. 2008;103:1206–14.

    Article  PubMed  Google Scholar 

  54. Rotheram-Borus MJ, Lee MB, Murphy DA, et al. Efficacy of a preventive intervention for youths living with HIV. Am J Public Health. 2001;91:400–5.

    Article  PubMed  CAS  Google Scholar 

  55. Rotheram-Borus MJ, Swendeman D, Comulada WS, et al. Prevention for substance-using HIV-positive young people: telephone and in-person delivery. J Acquir Immune Defic Syndr. 2004;37 Suppl 2:S68–77.

    Article  PubMed  Google Scholar 

  56. Rotheram-Borus MJ, Desmond K, Comulada WS, Arnold EM, Johnson M. Reducing risky sexual behavior and substance use among currently and formerly homeless adults living with HIV. Am J Public Health. 2009;99:1100–7.

    Article  PubMed  Google Scholar 

  57. Sorensen JL, Dilley J, London J, et al. Case management for substance abusers with HIV/AIDS: a randomized clinical trial. Am J Drug Alcohol Abuse. 2003;29:133–50.

    Article  PubMed  Google Scholar 

  58. Schroder KE, Carey MP, Vanable PA. Methodological challenges in research on sexual risk behavior: II. Accuracy of self-reports. Ann Behav Med. 2003;26:104–23.

    Article  PubMed  Google Scholar 

  59. Catania JA, Gibson DR, Chitwood DD, Coates TJ. Methodological problems in AIDS behavioral research: influences on measurement error and participation bias in studies of sexual behavior. Psychol Bull. 1990;108:339–62.

    Article  PubMed  CAS  Google Scholar 

  60. Weinhardt LS, Forsyth AD, Carey MP, Jaworski BC, Durant LE. Reliability and validity of self-report measures of HIV-related sexual behavior: progress since 1990 and recommendations for research and practice. Arch Sex Behav. 1998;27:155–80.

    Article  PubMed  CAS  Google Scholar 

  61. Midanik LT. Validity of self-reported alcohol use: a literature review and assessment. Br J Addict. 1988;83:1019–30.

    Article  PubMed  CAS  Google Scholar 

  62. Fiellin DA, McGinnis KA, Maisto SA, Justice AC, Bryant K. Measuring alcohol consumption using Timeline Followback in non-treatment-seeking medical clinic patients with and without HIV infection: 7-, 14-, or 30-day recall. J Stud Alcohol Drugs. 2013;74:500–4.

    PubMed  Google Scholar 

  63. Shiffman S. Ecological momentary assessment (EMA) in studies of substance use. Psychol Assess. 2009;21:486–97.

    Article  PubMed  Google Scholar 

  64. Jones J, Jones M, Plate C, et al. Liquid chromatography-tandem mass spectrometry assay to detect ethyl glucuronide in human fingernail: comparison to hair and gender differences. Am J Analyt Chem. 2012;3:83–91.

    Article  CAS  Google Scholar 

  65. Junghanns K, Graf I, Pflüger J, et al. Urinary ethyl glucuronide (EtG) and ethyl sulphate (EtS) assessment: valuable tools to improve verification of abstention in alcohol-dependent patients during in-patient treatment and at follow-ups. Addiction. 2009;104:921–6.

    Article  PubMed  Google Scholar 

  66. Bower JE, Kemeny ME, Fawzy FI. Group interventions for individuals with serious medical illness. In: Chesney M, Antoni MH, editors. Innovative approaches to health psychology: prevention and treatment lessons from AIDS. Washington D.C: American Psychological Association; 2002. p. 197–218.

    Chapter  Google Scholar 

  67. Kalichman SC, Catz SL. Stressors in HIV infection. In: Nott KH, Vedhara K, editors. Psychosocial and biomedical interactions in HIV infection. Amsterdam Netherlands: Harwood Academic; 2000. p. 31–60.

    Google Scholar 

  68. Riper H, van Straten A, Keuken M, et al. Curbing problem drinking with personalized-feedback interventions: a meta-analysis. Am J Prevent Med. 2009;36:247–55.

    Article  Google Scholar 

  69. McGinn LK, Sanderson WC. What allows cognitive behavioral therapy to be brief: overview, efficacy, and crucial factors facilitating brief treatment. Clin Psychol Sci Pract. 2001;8:23–37.

    Article  Google Scholar 

  70. Atkins DC, Bedics JD, McGlinchey JB, Beauchaine TP. Assessing clinical significance: does it matter which method we use? J of Consult and Clin Psychol. 2005;73:982–89.

    Google Scholar 

  71. Jacobson NS, Roberts LJ, Berns SB, McGlinchey JB. Methods for defining and determining clinical significance of treatment effects: description, application, alternatives. J of Consult and Clin Psychol. 1999;67:300–7.

    Google Scholar 

  72. Kazdin AE. The meanings and measurement of clinical significance. J of Consult and Clin Psychol. 1999;67:332–9.

    Google Scholar 

  73. Kendall PC, Marrs-Garcia A, Nath SR, Sheldrick RC. Normative comparisons for the evaluation of clinical significance. J of Consult and Clin Psychol. 1999;67:285–99.

    Google Scholar 

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Acknowledgments

Jennifer L. Brown was supported by K12 GM000680 from the National Institute of General Medical Sciences. Kelly S. DeMartini was supported by T32 AA015496 from the National Institute on Alcohol Abuse and Alcoholism. Andrea Swartzendruber was supported by F32AA022058 from the National Institute on Alcohol Abuse and Alcoholism. Jessica M. Sales was supported by K01MH085506 from the National Institute of Mental Health.

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Conflict of Interest

Jennifer L. Brown, Kelly S. DeMartini, Jessica M. Sales, and Andrea L. Swartzendruber declare that they have no conflict of interest

Ralph J. DiClemente is a consultant for the US Army and has received royalties from Jossey-Bass Publishers.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Psychology, Texas Tech University, Box 42051, Lubbock, TX, 79409-205, USA

    Jennifer L. Brown

  2. Department of Behavioral Sciences & Health Education, Emory University, Atlanta, GA, USA

    Jennifer L. Brown, Jessica M. Sales, Andrea L. Swartzendruber & Ralph J. DiClemente

  3. Center for AIDS Research, Emory University, Atlanta, GA, USA

    Jennifer L. Brown, Jessica M. Sales, Andrea L. Swartzendruber & Ralph J. DiClemente

  4. Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA

    Kelly S. DeMartini

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Correspondence to Jennifer L. Brown.

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Brown, J.L., DeMartini, K.S., Sales, J.M. et al. Interventions to Reduce Alcohol Use among HIV-Infected Individuals: A Review and Critique of the Literature. Curr HIV/AIDS Rep 10, 356–370 (2013). https://doi.org/10.1007/s11904-013-0174-8

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