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International Journal of Behavioral Medicine
Published in: International Journal of Behavioral Medicine 5/2014

01-10-2014

Viral Suppression and Antiretroviral Medication Adherence Among Alcohol Using HIV-Positive Adults

Authors: Seth C. Kalichman, Tamar Grebler, Christina M. Amaral, Megan McNerney, Denise White, Moira O. Kalichman, Chauncey Cherry, Lisa Eaton

Published in: International Journal of Behavioral Medicine | Issue 5/2014

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Abstract

Background

Substance use is a known predictor of poor adherence to antiretroviral therapies (ART) in people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome. Less studied is the association between substance use and treatment outcomes, namely, suppression of HIV replication.

Methods

Adults living with HIV (N = 183) who reported alcohol use in the previous week and receiving ART were observed over a 12-month period. Participants completed computer interviews, monthly unannounced pill counts to monitor ART adherence, and daily cell-phone delivered interactive-text assessments for alcohol use. HIV viral load was collected at baseline and 12-month follow-up from medical records. Analyses compared participants who had undetectable HIV viral loads at baseline and follow-up (sustained viral suppression) to those with unsustained viral suppression. Analyses also compared participants who were adherent to their medications (>85 % pills taken) over the year of observation to those who were nonadherent.

Results

Fifty-two percent of participants had unsustained viral suppression; 47 % were ART nonadherent. Overall results failed to demonstrate alcohol use as a correlate of sustained viral suppression or treatment adherence. However, alcohol use was associated with nonadherence among participants who did not have sustained viral suppression; nonadherence in unsustained viral suppression patients was related to drinking on fewer days of assessment, missing medications when drinking, and drinking socially.

Conclusions

Poor HIV treatment outcomes and nonadherence were prevalent among adults treated for HIV infection who drink alcohol. Drinking in relation to missed medications and drinking in social settings are targets for interventions among alcohol drinkers at greatest risk for poor treatment outcomes.
Literature
1.
2.
Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505. Epub 2011/07/20.PubMedCrossRefPubMedCentral
3.
Parienti JJ, Das-Douglas M, Massari V, Guzman D, Deeks SG, Verdon R, et al. Not all missed doses are the same: sustained NNRTI treatment interruptions predict HIV rebound at low-to-moderate adherence levels. PLoS ONE. 2008;3(7):e2783. Epub 2008/07/31.PubMedCrossRefPubMedCentral
4.
Kobin AB, Sheth NU. Levels of adherence required for virologic suppression among newer antiretroviral medications. The Annals of pharmacotherapy. 2011;45(3):372–9. Epub 2011/03/10.PubMedCrossRef
5.
Yard SS, Huh D, King KM, Simoni JM. Patient-level moderators of the efficacy of peer support and pager reminder interventions to promote antiretroviral adherence. AIDS Behav. 2011;15(8):1596–604. Epub 2011/07/09.PubMedCrossRefPubMedCentral
6.
Franke MF, Murray MB, Munoz M, Hernandez-Diaz S, Sebastian JL, Atwood S, et al. Food insufficiency is a risk factor for suboptimal antiretroviral therapy adherence among HIV-infected adults in urban Peru. AIDS Behav. 2011;15(7):1483–9. Epub 2010/08/18.PubMedCrossRefPubMedCentral
7.
Waldrop-Valverde D, Ownby RL, Wilkie FL, Mack A, Kumar M, Metsch L. Neurocognitive aspects of medication adherence in HIV-positive injecting drug users. AIDS Behav. 2006;10(3):287–97. Epub 2006/02/18.PubMedCrossRef
8.
Nilsson Schonnesson L, Williams ML, Ross MW, Bratt G, Keel B. Factors associated with suboptimal antiretroviral therapy adherence to dose, schedule, and dietary instructions. AIDS Behav. 2007;11(2):175–83. Epub 2006/08/24.PubMedCrossRef
9.
Hendershot CS, Stoner SA, Pantalone DW, Simoni JM. Alcohol use and antiretroviral adherence: review and meta-analysis. J Acquir Immune Defic Syndr. 2009;52(2):180–202. Epub 2009/08/12.PubMedCrossRefPubMedCentral
10.
Braithwaite RS, Kozal MJ, Chang CC, Roberts MS, Fultz SL, Goetz MB, et al. Adherence, virological and immunological outcomes for HIV-infected veterans starting combination antiretroviral therapies. AIDS. 2007;21(12):1579–89. Epub 2007/07/17.PubMedCrossRefPubMedCentral
11.
Braithwaite RS, McGinnis KA, Conigliaro J, Maisto SA, Crystal S, Day N, et al. A temporal and dose–response association between alcohol consumption and medication adherence among veterans in care. Alcoholism, clinical and experimental research. 2005;29(7):1190–7. Epub 2005/07/28.PubMedCrossRef
12.
Kalichman SC, Amaral CM, White D, Swetsze C, Pope H, Kalichman MO, et al. Prevalence and clinical implications of interactive toxicity beliefs regarding mixing alcohol and antiretroviral therapies among people living with HIV/AIDS. AIDS Patient Care STDs. 2009;23(6):449–54. Epub 2009/05/06.PubMedCrossRefPubMedCentral
13.
Sankar A, Wunderlich T, Neufeld S, Luborsky M. Sero-positive African Americans' beliefs about alcohol and their impact on anti-retroviral adherence. AIDS Behav. 2007;11(2):195–203. Epub 2006/06/27.PubMedCrossRef
14.
Piacenti FJ. An update and review of antiretroviral therapy. Pharmacotherapy. 2006;26(8):1111–33. Epub 2006/07/26.PubMedCrossRef
15.
Bertagnolio S, De Luca A, Vitoria M, Essajee S, Penazzato M, Hong SY, et al. Determinants of HIV drug resistance and public health implications in low- and middle-income countries. Antivir Ther. 2012;17(6):941–53. Epub 2012/08/18.PubMedCrossRef
16.
Bangsberg DR, Charlebois ED, Grant RM, Holodniy M, Deeks SG, Perry S, et al. High levels of adherence do not prevent accumulation of HIV drug resistance mutations. AIDS. 2003;17(13):1925–32. Epub 2003/09/10.PubMedCrossRef
17.
Bangsberg DR, Moss AR, Deeks SG. Paradoxes of adherence and drug resistance to HIV antiretroviral therapy. J Antimicrob Chemother. 2004;53(5):696–9. Epub 2004/03/27.PubMedCrossRef
18.
Gribble JN, Miller HG, Cooley PC, Catania JA, Pollack L, Turner CF. The impact of T-ACASI interviewing on reported drug use among men who have sex with men. Subst Use Misuse. 2000;35(6–8):869–90. Epub 2000/06/10.PubMedCrossRef
19.
Morrison-Beedy D, Carey MP, Tu X. Accuracy of audio computer-assisted self-interviewing (ACASI) and self-administered questionnaires for the assessment of sexual behavior. AIDS Behav. 2006;10(5):541–52. Epub 2006/05/25.PubMedCrossRefPubMedCentral
20.
Saunders JB, Aasland OG, Babor TF, DeLaFuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption II. Addictions. 1993;88(6):791–804.CrossRef
21.
Maisto SA, Conigliaro J, McNeil M, Kraemer K, Kelley ME. An empirical investigation of the factor structure of the AUDIT. Psychol Assess. 2000;12(3):346–53. Epub 2000/10/06.PubMedCrossRef
22.
Bangsberg DR, Hecht FM, Charlebois ED, Chesney M, Moss A. Comparing objective measures of adherence to HIV antiretroviral therapy: Electronic medication monitors and unannounced pill counts. AIDS and Behavior. 2001;5:275–81.CrossRef
23.
Kalichman SC, Amaral CM, Cherry C, Flanagan JA, Pope H, Eaton L, et al. Monitoring antiretroviral adherence by unannounced pill counts conducted by telephone: reliability and criterion-related validity. HIV Clinical Trials. 2008;9:298–308.PubMedCrossRefPubMedCentral
24.
Kalichman SC, Amaral CM, Stearns HL, White D, Flanagan JA, Pope H, et al. Adherence to antiretroviral therapy assessed by unannounced pill counts conducted by telephone. Journal of General Internal Medicine. 2007;22:1003–6.PubMedCrossRefPubMedCentral
25.
Chesney MA, Ickovics JR, Chambers DB, Gifford AL, Neidig J, Zwickl B, et al. Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG adherence instruments. Patient Care Committee & Adherence Working Group of the Outcomes Committee of the Adult AIDS Clinical Trials Group (AACTG). AIDS Care. 2000;12(3):255–66. Epub 2000/08/06.PubMedCrossRef
26.
Ickovics JR, Meisler AW. Adherence in AIDS clinical trials: a framework for clinical research and clinical care. J Clin Epidemiol. 1997;50(4):385–91. Epub 1997/04/01.PubMedCrossRef
27.
Simoni J, Kurth AE, Pearson C, Pantalone DW, Merrill J, Frick P. Self-report measures of antiretroviral therapy adherence: a review with recommendations for HIV research and clinical management. AIDS Behavior. 2006;10:227–331.PubMedCrossRefPubMedCentral
28.
Bernhardt JM, Usdan S, Mays D, Martin R, Cremeens J, Arriola KJ. Alcohol assessment among college students using wireless mobile technology. J Stud Alcohol Drugs. 2009;70(5):771–5. Epub 2009/09/10.PubMedPubMedCentral
29.
McAuliffe TL, DiFranceisco W, Reed BR. Low numeracy predicts reduced accuracy of retrospective reports of frequency of sexual behavior. AIDS Behav. 2010;14(6):1320–9. Epub 2010/07/20.PubMedCrossRefPubMedCentral
30.
Harel O, Pellowski J, Kalichman S. Are we missing the importance of missing values in HIV prevention randomized clinical trials? Review and recommendations. AIDS Behav. 2012;16:1382–93. Epub 2012/01/10
31.
Bangsberg D, Kroetz DL, Deeks S. Adherence–resistance relationships to combination HIV antiretroviral therapy. Current HIV/AIDS Reports. 2007;4:65–72.PubMedCrossRef
32.
33.
Rasbach DA, Desruisseau AJ, Kipp AM, Stinnette S, Kheshti A, Shepherd BE, et al. Active cocaine use is associated with lack of HIV-1 virologic suppression independent of nonadherence to antiretroviral therapy: use of a rapid screening tool during routine clinic visits. AIDS Care. 2013;25(1):109–17. Epub 2012/06/08.PubMedCrossRefPubMedCentral
34.
Mantri CK, Pandhare Dash J, Mantri JV, Dash CC. Cocaine enhances HIV-1 replication in CD4+ T cells by down-regulating MiR-125b. PLoS ONE. 2012;7(12):e51387. Epub 2012/12/20.PubMedCrossRefPubMedCentral
35.
Weinhardt LS, Carey MP. Does alcohol lead to sexual risk behavior? Findings from event-level research. Annu Rev Sex Res. 2000;11:125–57. Epub 2001/05/16.PubMedPubMedCentral
36.
Bangsberg DR, Kroetz DL, Deeks SG. Adherence-resistance relationships to combination HIV antiretroviral therapy. Curr HIV/AIDS Rep. 2007;4(2):65–72. Epub 2007/06/06.PubMedCrossRef
37.
38.
Miller WR. Are alcoholism treatments effective? The Project MATCH data: response. BMC Public Health. 2005;5:76. Epub 2005/07/20.
39.
Anton RF, O'Malley SS, Ciraulo DA, Cisler RA, Couper D, Donovan DM, et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA. 2006;295(17):2003–17. Epub 2006/05/04.PubMedCrossRef
40.
Simoni JM, Frick PA, Lockhart D, Liebovitz D. Mediators of social support and antiretroviral adherence among an indigent population in New York City. AIDS Patient Care STDs. 2002;16(9):431–9. Epub 2002/10/25.PubMedCrossRef
Metadata
Title
Viral Suppression and Antiretroviral Medication Adherence Among Alcohol Using HIV-Positive Adults
Authors
Seth C. Kalichman
Tamar Grebler
Christina M. Amaral
Megan McNerney
Denise White
Moira O. Kalichman
Chauncey Cherry
Lisa Eaton
Publication date
01-10-2014
Publisher
Springer US
Published in
International Journal of Behavioral Medicine / Issue 5/2014
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI
https://doi.org/10.1007/s12529-013-9353-7

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