Longitudinal association of alcohol use with HIV disease progression and psychological health of women with HIV (original) (raw)
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The impact of alcohol use on depressive symptoms in human immunodeficiency virus-infected patientsâ€
Addiction, 2008
Aims-To examine the impact of alcohol use on depressive symptoms in HIV-infected patients. Design-Data were collected at 6-month intervals and analyzed to evaluate the association between alcohol dependence and consumption on depressive symptoms using longitudinal mixed effects regression models controlling for specified covariates. Measurements-The two independent variables were current alcohol dependence assessed using the Composite International Diagnostic Interview (CIDI) and past month consumption (heavy versus not heavy drinking) using a validated calendar-based method. The primary outcome was depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale (CES-D). Participants-HIV-infected adults with current or past alcohol problems. Findings-Alcohol dependence and heavy alcohol use were significantly associated with higher CES-D scores in unadjusted models. In adjusted analyses, the association of current alcohol dependence persisted (mean difference in CES-D was 3.49 for dependence vs. non-dependence; 95% CI: 1.76-5.22), however the effect of heavy drinking was no longer statistically significant (mean difference in CES-D was 1.04 for heavy vs. not heavy drinking; 95% CI:-0.24-2.32). Conclusions-Alcohol use is associated with more depressive symptoms in HIV-infected patients with alcohol problems. This association remains significant after adjusting for potential confounders only when alcohol use meets criteria for alcohol dependence.
The influence of depressive symptoms on alcohol use among HIV-infected Russian drinkers
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.
AIDS Care, 2020
Although there is evidence of individual associations between depressive symptoms and hazardous alcohol use with suboptimal antiretroviral therapy (ART) adherence among people living with HIV (PLWH), few studies have established how the two risk factors may interact to predict viral suppression. We conducted secondary data analyses with two cohorts of Ugandan PLWH (N = 657) to investigate the hypothesized interaction between depressive symptoms (Center for Epidemiological Studies Depression Scale) and hazardous alcohol use (Alcohol Use Disorder Identification Test-Consumption and/or Phosphatidylethanol biomarker) prior to ART initiation with viral suppression (<550 copies/ml). We were unable to detect an interaction between depressive symptoms and hazardous alcohol use prior to ART initiation with viral suppression in the first two years (M = 19.9 months) after ART initiation (p = 0.75). There was also no evidence of a main effect association for depressive symptoms (Adjusted Odds Ratio [AOR] = 0.88, 95% Confidence Interval [CI]: 0.50, 1.55) or hazardous alcohol use (AOR = 1.37, 95% CI: 0.80, 2.33). PLWH with depressive symptoms and/or hazardous alcohol use appear to exhibit similar levels of viral suppression as others in care; further work is needed to determine effects on HIV testing and treatment engagement.
Alcohol Consumption Trajectory Patterns in Adult Women with HIV Infection
AIDS and Behavior, 2013
HIV-infected women with excessive alcohol consumption are at risk for adverse health outcomes, but little is known about their long-term drinking trajectories. This analysis included longitudinal data, obtained from 1996-2006, from 2791 women with HIV from the Women's Interagency HIV Study. Among these women, the proportion in each of five distinct drinking trajectories was: continued heavy drinking (3%), reduction from heavy to non-heavy drinking (4%), increase from non-heavy to heavy drinking (8%), continued non-heavy drinking (36%), and continued nondrinking (49%). Depressive symptoms, other substance use (crack/cocaine, marijuana, and tobacco), co-infection with HCV, and heavy drinking prior to enrollment were associated with trajectories involving future heavy drinking. In conclusion, many women with HIV change their drinking patterns over time. Clinicians and those providing alcohol-related interventions might target those with depression, current use of tobacco or illicit drugs, HCV infection, or a previous history of drinking problems.
Intersecting alcohol use and depression impedes HIV treatment in the rural South, USA
Behavioral Medicine, 2020
This study tested the hypothesis that the co-occurrence of alcohol use and depressive symptoms predicts HIV suppression and antiretroviral therapy (ART) adherence among people living with HIV. Baseline cross-sectional results showed a significant interaction between depressive symptoms and alcohol use in predicting HIV suppression; individuals who drank more alcohol and had higher depressive symptoms demonstrated poorer HIV suppression relative to those who had fewer depressive symptoms. In a one-year longitudinal analysis of ART adherence, alcohol use and depressive symptoms measured in daily text-message assessments demonstrated that neither alcohol use nor depressive symptoms alone predicted ART adherence. However, the intersection of alcohol use on days when experiencing depressive symptoms did significantly predict ART non-adherence, for both moderate and heavy alcohol drinkers. Findings suggest that the co-occurrence of alcohol use and depressive symptoms is a robust predictor of poor HIV treatment outcomes.
AIDS and Behavior
Although alcohol use is associated with depression, it is unclear if brief alcohol reduction interventions can ameliorate depression and psychological distress among people with HIV (PWH). We use data from a two-arm randomised controlled trial to examine this question. PWH on antiretroviral treatment (ART) were randomly assigned to receive a brief intervention or treatment as usual (n = 622). Screening was done with the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-C, Centre for Epidemiological Studies Depression inventory and Kessler Psychological Distress Scale, at baseline and at 3- and 6-months post-baseline. Changes in depression and psychological distress was assessed using analysis of covariance models with baseline measures of alcohol consumption, sex and age included as covariates and adjusting for baseline symptom severity. Changes in alcohol consumption between baseline and follow-up were included in the analysis to establish if this affected outcomes. For both...
AIDS Care, 2014
Hazardous drinking is common among persons living with HIV/AIDS (PLWHA) and associated with numerous negative health consequences. Despite the well-established negative effects of hazardous drinking among PLWHA, scholarly work has neglected to explore the role of such drinking in regard to anxiety/depressive symptoms and HIV symptom expression. The current study investigated the explanatory value of hazardous drinking in relation to anxiety/depressive symptoms and HIV symptoms among PLWHA. Participants (n = 94; 88.3% male; Mage = 48.55; SD = 9.15) included adults living with HIV/AIDS recruited from AIDS service organizations in the Northeast. Hazardous drinking was significantly associated with all outcome variables above and beyond the variance accounted for by sex, race, recruitment site, CD4 t-cell count, as well as other cognitive-affective variables (emotion dysregulation, distress intolerance, and anxiety sensitivity). The present results provide empirical support that hazardous drinking is indeed related to depressive and anxiety symptoms as well as HIV symptom distress and that this effect is not attributable to other factors commonly related to both alcohol use problems and emotional distress among PLWHA. Results highlight the importance of alcohol interventions for excessive drinking specifically tailored for PLWHA to facilitate better mental and physical health adjustment.
HIV & AIDS Review, 2021
Introduction: Amidst unfavorable effects of alcohol and other substances on the course and outcomes of human immunodeficiency virus (HIV) infection, this study aimed at identifying patterns of alcohol and substance usage and their association with gender and presence of psychological distress among people living with HIV/acquired immunodeficiency syndrome (AIDS) (PLWHA). Material and methods: Using a cross-sectional survey, questionnaires with socio-demographic variables, Kessler psychological distress (K-10), and the condensed alcohol, smoking, and substance involvement screening test (ASSIST) were administered to PLWHA attending HIV clinic at the State University Teaching Hospital, Ado-Ekiti, Nigeria. Lifetime and current substance use as well as levels of risky use of alcohol and other substances were determined, and their relationship with gender and psychological distress were verified using bivariate statistics. Results: Among 297 participants, the majority were females (72.0%), with mean age of 37.49 years (SD = 10.02). Lifetime and current prevalence were alcohol 62.6% and 37.0%; cannabis 6.1% and 2.7%; nicotine 14.8% and 6.1%; and sedatives 43.1% and 15.4%, respectively. Males were more likely to drink alcohol, use cannabis, and smoke cigarettes than their female counterparts (p < 0.001). Those who were current sedatives users were more likely to be experiencing psychological distress (p = 0.023). Conclusions: Despite the negative effect of alcohol on the course and outcomes of HIV infection, a higher proportion of the participants had a history of lifetime and current alcohol and other substance use, with the majority of current substance users being a moderate-to high-risk users. Interventions aimed at reducing excessive substance use are needed to optimize treatment outcomes.