Not all non-drinkers with HIV are equal: demographic and clinical comparisons among current non-drinkers with and without a history of prior alcohol use disorders*

Heidi M. Crane, Robin M. Nance, Joseph O. Merrill, Heidi Hutton, Geetanjali Chander, Mary E. McCaul, W. Chris Mathews, Rob Fredericksen, Jane M. Simoni, Kenneth Mayer, Michael J. Mugavero, James H. Willig, Greer Burkholder, Daniel R. Drozd, Matthew Mimiaga, Bryan Lau, H. Nina Kim, Karen Cropsey, Richard D. Moore, Katerina ChristopoulosElvin Geng, Joseph J. Eron, Sonia Napravnik, Mari M. Kitahata, Michael S. Saag, Joseph A.C. Delaney

Research output: Contribution to journalArticle

Abstract

Studies of persons living with HIV (PLWH) have compared current non-drinkers to at-risk drinkers without differentiating whether current non-drinkers had a prior alcohol use disorder (AUD). The purpose of this study was to compare current non-drinkers with and without a prior AUD on demographic and clinical characteristics to understand the impact of combining them. We included data from six sites across the US from 1/2013 to 3/2015. Patients completed tablet-based clinical assessments at routine clinic appointments using the most recent assessment. Current non-drinkers were identified by AUDIT-C scores of 0. We identified a prior probable AUD by a prior AUD diagnosis in the electronic medical record (EMR) or a report of attendance at alcohol treatment in the clinical assessment. We used multivariate logistic regression to examine factors associated with prior AUD. Among 2235 PLWH who were current non-drinkers, 36% had a prior AUD with more patients with an AUD identified by the clinical assessment than the EMR. Higher proportions with a prior AUD were male, depressed, and reported current drug use compared to non-drinkers without a prior AUD. Former cocaine/crack (70% vs. 25%), methamphetamine/crystal (49% vs. 16%), and opioid/heroin use (35% vs. 7%) were more commonly reported by those with a prior AUD. In adjusted analyses, male sex, past methamphetamine/crystal use, past marijuana use, past opioid/heroin use, past and current cocaine/crack use, and cigarette use were associated with a prior AUD. In conclusion, this study found that among non-drinking PLWH in routine clinical care, 36% had a prior AUD. We found key differences between those with and without prior AUD in demographic and clinical characteristics, including drug use and depression. These results suggest that non-drinkers are heterogeneous and need further differentiation in studies and that prior alcohol misuse (including alcohol treatment) should be included in behavioural health assessments as part of clinical care.

Original languageEnglish (US)
Pages (from-to)177-184
Number of pages8
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume29
Issue number2
DOIs
StatePublished - Feb 1 2017

Keywords

  • HIV
  • adherence
  • alcohol use
  • alcohol use disorders
  • substance use

ASJC Scopus subject areas

  • Social Psychology
  • Health(social science)
  • Public Health, Environmental and Occupational Health

Fingerprint Dive into the research topics of 'Not all non-drinkers with HIV are equal: demographic and clinical comparisons among current non-drinkers with and without a history of prior alcohol use disorders<sup>*</sup>'. Together they form a unique fingerprint.

  • Cite this

    Crane, H. M., Nance, R. M., Merrill, J. O., Hutton, H., Chander, G., McCaul, M. E., Mathews, W. C., Fredericksen, R., Simoni, J. M., Mayer, K., Mugavero, M. J., Willig, J. H., Burkholder, G., Drozd, D. R., Mimiaga, M., Lau, B., Kim, H. N., Cropsey, K., Moore, R. D., ... Delaney, J. A. C. (2017). Not all non-drinkers with HIV are equal: demographic and clinical comparisons among current non-drinkers with and without a history of prior alcohol use disorders*. AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, 29(2), 177-184. https://doi.org/10.1080/09540121.2016.1204418