Characterizing Unhealthy Alcohol Use Patterns and Their Association with Alcohol Use Reduction and Alcohol Use Disorder During Follow-Up in HIV Care

Thibaut Davy-Mendez; Varada Sarovar; Tory Levine-Hall; Alexandra N Lea; Stacy A Sterling; Felicia W Chi; Vanessa A Palzes; Mitchell N Luu; Jason A Flamm; C Bradley Hare; Emily C Williams; Kendall J Bryant; Constance M Weisner; Michael J Silverberg; Derek D Satre

doi:10.1007/s10461-022-03873-5

Characterizing Unhealthy Alcohol Use Patterns and Their Association with Alcohol Use Reduction and Alcohol Use Disorder During Follow-Up in HIV Care

AIDS Behav. 2023 May;27(5):1380-1391. doi: 10.1007/s10461-022-03873-5. Epub 2022 Sep 28.

Authors

Thibaut Davy-Mendez^{1

2

3}, Varada Sarovar⁴, Tory Levine-Hall⁴, Alexandra N Lea⁴, Stacy A Sterling⁴, Felicia W Chi⁴, Vanessa A Palzes⁴, Mitchell N Luu⁵, Jason A Flamm⁶, C Bradley Hare⁷, Emily C Williams^{8

9}, Kendall J Bryant¹⁰, Constance M Weisner⁴, Michael J Silverberg⁴, Derek D Satre^{11

4}

Affiliations

¹ Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA. [email protected].
² Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA. [email protected].
³ Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, 130 Mason Farm Rd., CB #7030, Chapel Hill, NC, 27599, USA. [email protected].
⁴ Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
⁵ Oakland Medical Center, Kaiser Permanente Northern California, Oakland, CA, USA.
⁶ Sacramento Medical Center, Kaiser Permanente Northern California, Sacramento, CA, USA.
⁷ San Francisco Medical Center, Kaiser Permanente Northern California, San Francisco, CA, USA.
⁸ Center of Innovation for Veteran Centered and Value-Driven Care, Veterans Affairs Puget Sound, Seattle, WA, USA.
⁹ Department of Health Services, University of Washington, Seattle, WA, USA.
¹⁰ National Institute on Alcohol Abuse and Alcoholism HIV/AIDS Program, Bethesda, MD, USA.
¹¹ Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.

Abstract

Outcomes of PWH with unhealthy alcohol use, such as alcohol use reduction or progression to AUD, are not well-known and may differ by baseline patterns of unhealthy alcohol use. Among 1299 PWH screening positive for NIAAA-defined unhealthy alcohol use in Kaiser Permanente Northern California, 2013-2017, we compared 2-year probabilities of reduction to low-risk/no alcohol use and rates of new AUD diagnoses by baseline use patterns, categorized as exceeding: only daily limits (72% of included PWH), only weekly limits (17%), or both (11%), based on NIAAA recommendations. Overall, 73.2% (95% CI 70.5-75.9%) of re-screened PWH reduced to low-risk/no alcohol use over 2 years, and there were 3.1 (95% CI 2.5-3.8%) new AUD diagnoses per 100 person-years. Compared with PWH only exceeding daily limits at baseline, those only exceeding weekly limits and those exceeding both limits were less likely to reduce and likelier to be diagnosed with AUD during follow-up. PWH exceeding weekly drinking limits, with or without exceeding daily limits, may have a potential need for targeted interventions to address unhealthy alcohol use.

Keywords: Alcohol use disorder; HIV; Unhealthy alcohol use.

MeSH terms

Alcohol Drinking / epidemiology
Alcoholism* / complications
Alcoholism* / epidemiology
Follow-Up Studies
HIV Infections* / complications
HIV Infections* / epidemiology
HIV Infections* / prevention & control
Health Behavior
Humans

Abstract

MeSH terms

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