Cited by 133HIV, Drug Use, Sexual RiskSubstance Abuse Treatment and OutcomesHIV/AIDS Research and Interventions

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Behavioral Interventions Targeting Alcohol Use Among People Living with HIV/AIDS: A Systematic Review and Meta-Analysis

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The MASH Research Team, Scott-Sheldon, Lori A. J., Carey, Kate B., Johnson, Blair T., Carey, Michael P.·2017·AIDS and Behavior

DOI 10.1007/s10461-017-1886-3PMC PMC5660648

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Abstract

Alcohol use is often reported among people living with HIV/AIDS (PLWHA) and is associated with increased sexual risk and poor medication adherence. This meta-analysis evaluated the efficacy of behavioral interventions addressing alcohol use among PLWHA. Twenty-one studies (N = 8461 PLWHA) that evaluated an individual-level intervention addressing alcohol use alone or as part of a more comprehensive alcohol/HIV intervention, included a control condition, and were available through December 2016 were included. Independent raters coded study, sample, and intervention content. Weighted mean effect sizes, using random-effects models, were calculated. Results indicate that interventions reduced alcohol consumption, increased condom use, and improved medication adherence relative to controls (d +s = 0.10-0.24). Plasma viral load was also reduced in intervention versus control participants (d + = 0.14, 95% CI = 0.02, 0.26; k = 7). These findings show that behavioral interventions addressing alcohol use can successfully reduce alcohol consumption and also improve HIV-related outcomes among PLWHA.

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Current Interventions for People Living with HIV Who Use Alcohol: Why Gender Matters
Wechsberg, W. M., Browne, F. A., Bonner, C. P., Washio, Y., Howard, B. N., & van der Drift, I. (2021) · Current HIV/AIDS Reports · doi:10.1007/s11904-021-00558-x · Cited by 10
“Research is growing to address the intersection of alcohol misuse among PLWH [15].”
Background
Pornography, identification, alcohol, and condomless sex
Wright, P. J., Tokunaga, R. S., & Herbenick, D. (2024) · Journal of Communication · doi:10.1093/joc/jqae009 · Cited by 12
Optimizing the delivery of interventions for harmful alcohol use in primary healthcare
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Implementation of two alcohol reduction interventions among persons with hazardous alcohol use who are living with HIV in Thai Nguyen, Vietnam: a micro-costing analysis
Blackburn, N. A., Go, V. F.-L., Bui, Q., Hutton, H. E., Tampi, R. P., Sripaipan, T., Hà, T. V., Latkin, C. A., Golden, S. D., Golin, C. E., et al. (2020) · Global Health Action · doi:10.1080/16549716.2020.1814035 · Cited by 10
“alcohol use and are demonstrated as cost-effective in high-resource countries [4].”
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Dual trajectories of antiretroviral therapy adherence and polypharmacy in women with HIV in the United States
Elbur, A. I., Ghebremichael, M. S., Konkle‐Parker, D. J., Jones, D. L., Collins, S., Adimora, A. A., Schneider, M. F., Cohen, M. H., Tamraz, B., Plankey, M. W., et al. (2023) · AIDS Research and Therapy · doi:10.1186/s12981-023-00520-4 · Cited by 10
“that address both adherence and alcohol consumption, as such interventions have been shown to reduce alcohol consumption and improve treatment outcomes [28].”
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Acceptance and Commitment Therapy (ACT) for HIV-infected Hazardous Drinkers: A Qualitative Study of Acceptability
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Social Cognitive Theory as a Theoretical Framework to Predict Sexual Risk Behaviors among Older Adults
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Adherence to antiretroviral therapy among cisgender gay, bisexual and other men who have sex with men in Brazil: Evaluating the role of HIV-related stigma dimensions
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‘What will it take’: addressing alcohol use among people living with HIV in South Africa
Sorsdahl, K. R., Morojele, N. K., Parry, C. D. H., Kekwaletswe, C. T., Kitleli, N. B., Malan, M., Shuper, P. A., & MYERS, B. J. (2019) · International Journal of STD & AIDS · doi:10.1177/0956462419862899 · Cited by 9
‘We have goals but [it is difficult]’. Barriers to antiretroviral therapy adherence among women using alcohol and other drugs living with HIV in South Africa
Ndirangu, J. W., Gichane, M. W., Browne, F. A., Bonner, C. P., Zule, W. A., Cox, E. N., Smith, K. M., Carney, T., & Wechsberg, W. M. (2022) · Health Expectations · doi:10.1111/hex.13422 · Cited by 10
Telehealth interventions to reduce alcohol use in men with HIV who have sex with men: Protocol for a factorial randomized controlled trial
Kahler, C. W., Surace, A., Durst, A., Pantalone, D. W., Mastroleo, N. R., Míguez, M. J., Bueno, D., Liu, T., Monti, P. M., & Mayer, K. H. (2019) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2019.100475 · Cited by 9
“Multiple randomized controlled trials have provided evidence for the efficacy of behavioral interventions for reducing alcohol use in people living with HIV [72], with some evidence that interventions with a primary focus on alcohol use—as opposed to alcohol use being one of a number of intervention targets—have parti…”
Background
The CARES Program: Improving Viral Suppression and Retention in Care Through a Comprehensive Team-Based Approach to Care for People with HIV and Complex Psychosocial Needs
Sweitzer, S., Giegold, M., Chen, Y., Farber, E. W., Sumitani, J., Henderson, A., Easley, K. A., Armstrong, W. S., Colasanti, J. A., Ammirati, R. J., et al. (2023) · AIDS Patient Care and STDs · doi:10.1089/apc.2023.0061 · Cited by 7
MAIN REASONS AND CURRENT METHODS OF CORRECTION OF POOR ADHERENCE TO ANTIRETROVIRAL TREATMENT IN DIFFICULT PATIENTS
Борисович, М. В., Yakovlev, A. A., Chaika, N. A., Kelly, J. A., & Amirkhanian, Y. A. (2019) · HIV Infection and Immunosuppressive Disorders · doi:10.22328/2077-9828-2018-10-4-37-56 · Cited by 7
Believing That It Is Hazardous to Mix Alcohol With Medicines Predicts Intentional Nonadherence to Antiretrovirals
Kalichman, S. C., Eaton, L. A., & Kalichman, M. O. (2022) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000002933 · Cited by 7
An agent-based model of binge drinking, inequitable gender norms and their contribution to HIV transmission, with application to South Africa
Johnson, L. F., Kubjane, M., de Voux, A., Ohrnberger, J., & Tlali, M. (2023) · BMC Infectious Diseases · doi:10.1186/s12879-023-08470-y · Cited by 6
The effect of an economic empowerment and relationship strengthening intervention on food insecurity among couples living with HIV in Malawi
Kiyingi, J., Ssewamala, F. M., Neilands, T. B., Tebbetts, S., Mulauzi, N., Mkandawire, J., & Conroy, A. A. (2025) · BMC Public Health · doi:10.1186/s12889-025-23911-w · Cited by 6
Executive summary of the consensus document on the shared care of patients with HIV infection between primary and hospital care
Martínez‐Sanz, J., Losa, J. E., Orozco, N., Alastrué, I., Mascort, J., & Pérez-Elı́as, M. J. (2024) · Enfermedades Infecciosas y Microbiología Clínica · doi:10.1016/j.eimc.2023.05.006 · Cited by 6
Effects of Two Alcohol Reduction Interventions on Depression and Anxiety Symptoms of ART Clients in Vietnam
Nguyen, M. X., Reyes, H. L. M., Pence, B. W., Muessig, K. E., Hutton, H. E., Latkin, C. A., Dowdy, D. W., Chander, G., Lancaster, K. E., Frangakis, C., et al. (2021) · AIDS and Behavior · doi:10.1007/s10461-021-03532-1 · Cited by 7
“Alcohol reduction interventions drawing on both MET/MI and CBT have successfully reduced alcohol consumption, increased condom use, and improved ART adherence among PWH [32, 34, 37].”
Background
Integrating Depression and Alcohol Use Care Into Primary Care in Low- and Middle-Income Countries: A Meta-Analysis
Park, S., Cubillos, L., Martínez‐Camblor, P., Bartels, S. M., Torrey, W. C., John, D. T., Cepeda, M., Bell, K. R., Castro, S., Suárez‐Obando, F., et al. (2023) · Psychiatric Services · doi:10.1176/appi.ps.20220267 · Cited by 6
Contingency management with stepped care for unhealthy alcohol use among individuals with HIV: Protocol for a randomized controlled trial
Edelman, E. J., Dziura, J. D., Deng, Y., DePhilippis, D., Fucito, L. M., Ferguson, T. F., Bedimo, R., Brown, S. T., Marconi, V. C., Goetz, M. B., et al. (2023) · Contemporary Clinical Trials · doi:10.1016/j.cct.2023.107242 · Cited by 6
Perspectives on contingency management for alcohol use and alcohol‐associated conditions among people in care with HIV
Cohen, S. M., DePhilippis, D., Deng, Y., Dziura, J. D., Ferguson, T. F., Fucito, L. M., Justice, A. C., Maisto, S. A., Marconi, V. C., Molina, P. E., et al. (2023) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.15159 · Cited by 6
ReACH2Gether: Iterative Development of a Couples-Based Intervention to Reduce Alcohol use Among Sexual Minority Men Living with HIV and Their Partners
Gamarel, K. E., Durst, A., Zelaya, D. G., van den Berg, J. J., Souza, T., Johnson, M. O., Wu, E., Monti, P. M., & Kahler, C. W. (2023) · AIDS and Behavior · doi:10.1007/s10461-023-04148-3 · Cited by 6
“As a result, there have been several individual-level behavioral interventions developed to reduce unhealthy alcohol use among people living with HIV [10, 11], including sexual minority men [12–14].”
The Role of Alcohol-Related Behavioral Research in the Design of HIV Secondary Prevention Interventions in the Era of Antiretroviral Therapy: Targeted Research Priorities Moving Forward
Shuper, P. A. (2021) · AIDS and Behavior · doi:10.1007/s10461-021-03302-z · Cited by 6
“’s meta-analysis [34] found that the delivery of alcohol-focused interventions among PLWH populations led to significant reductions in alcohol consumption, as well as improvements in ART adherence and HIV viral suppression.”
Background
Concordance Between Point-of-Care Urine Ethyl Glucuronide Alcohol Tests and Self-Reported Alcohol Use in Persons with HIV in Uganda
Alcover, K. C., Emenyonu, N. I., Fatch, R., Kekibiina, A., Marson, K. G., Chamie, G., Muyindike, W. R., Beesiga, B., Kamya, M. R., Lodi, S., et al. (2022) · AIDS and Behavior · doi:10.1007/s10461-022-03597-6 · Cited by 6
Fresh Perspectives on the Alcohol and HIV Nexus: A Call for Action in an Era of Increased Opportunities and Challenges
Parry, C. D. H., Tomlinson, M., BRYANT, K. J., & Rotherham-Borus, M. J. (2017) · AIDS and Behavior · doi:10.1007/s10461-017-1917-0 · Cited by 6
Costs of a Brief Alcohol Consumption Reduction Intervention for Persons Living with HIV in Southwestern Uganda: Comparisons of Live Versus Automated Cell Phone-Based Booster Components
Hahn, J. A., Kevany, S., Emenyonu, N. I., Sanyu, N., Katusiime, A., Muyindike, W. R., Fatch, R., & Shade, S. B. (2023) · AIDS and Behavior · doi:10.1007/s10461-023-04010-6 · Cited by 4
Efficacy of Behavioral Intervention, Text Messaging, and Extended Intervention to Address Alcohol Misuse in Sexual Minority Men with HIV: A Factorial Randomized Clinical Trial
Kahler, C. W., Surace, A., Liu, T., Pantalone, D. W., Mastroleo, N. R., Yan, Y., Wray, T. B., Mayer, K. H., & Monti, P. M. (2024) · AIDS and Behavior · doi:10.1007/s10461-024-04493-x · Cited by 4
Leveraging U = U in Interventions for Black Women Living With HIV: A Scoping Review and Call To Action
Jones, M. A., Sawyer, S., Bowman, I., Habib, M. A., Wassertzug, D., & Taggart, T. (2025) · AIDS and Behavior · doi:10.1007/s10461-025-04670-6 · Cited by 4
Alcohol interventions for persons with HIV: Meta-analysis of randomized controlled trials using phosphatidylethanol and self-report
Hahn, J. A., Kane, J. C., Fatch, R., da Silva, C. E., Emenyonu, N. I., Scheffler, A., Chirayil, P., So‐Armah, K., Kahler, C. W., Conroy, A. A., et al. (2025) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2025.112879 · Cited by 4
Development and Cultural Adaptation of a Computer-Delivered and Multi-Component Alcohol Reduction Intervention for Russian Women Living with HIV and HCV
Brown, J. L., Anastasakis, I., Revzina, N., Capasso, A., Boeva, E. V., Рассохин, В. В., Crusey, A., Sales, J. M., Hitch, A. E., Renfro, T. L., et al. (2021) · Journal of the International Association of Providers of AIDS Care (JIAPAC) · doi:10.1177/23259582211044920 · Cited by 4
Integrated Stepped Alcohol Treatment With Contingency Management for Unhealthy Alcohol Use Among People With HIV: A Randomized Controlled Trial
Edelman, E. J., Dziura, J. D., Deng, Y., DePhilippis, D., Ferguson, T. F., Brown, S. T., Marconi, V. C., Goetz, M. B., Rodriguez‐Barradas, M. C., Simberkoff, M. S., et al. (2024) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000003534 · Cited by 6
Telemedicine for unhealthy alcohol use in adults living with HIV in Alabama using common elements treatment approach: A hybrid clinical efficacy-implementation trial protocol
Gagnon, K. W., Levy, S. M., Figge, C. J., Wolford‐Clevenger, C., Murray, L. K., Kane, J. C., Bosomprah, S., Sharma, A., Nghiem, V. T. H., Chitambi, C., et al. (2023) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2023.101123 · Cited by 4
Examining Alcohol Interventions Across the Lifespan among the African Diaspora: A Systematic Review
Marshall, V. J., Vieira, D. L., McLaurin-Jones, T. L., & Lashley, M.-B. (2022) · Journal of the National Medical Association · doi:10.1016/j.jnma.2022.06.001 · Cited by 3
Predictors of Viral Suppression Among People Living with HIV in Rural Oregon
Menza, T. W., Jensen, A., & Hixson, L. K. (2023) · AIDS and Behavior · doi:10.1007/s10461-023-04145-6 · Cited by 3
Economic and relationship-strengthening intervention to reduce alcohol use in couples living with HIV in Malawi: a study protocol for a randomised controlled trial of Mlambe
Mkandawire, J., Ssewamala, F. M., Hahn, J. A., Mulauzi, N., Neilands, T. B., Tebbetts, S., Darbes, L. A., Brown, D. S., & Conroy, A. A. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-097247 · Cited by 3
Antiretroviral Therapy Adherence and Clinic Attendance Over Time Among People in Argentina Living with HIV and Lost to Care
Sued, O. G., Rodriguez, V. J., Weiss, S. M., Alcaide, M. L., Cecchini, D. M., Cahn, P. E., Cassetti, I., Kaminsky, C. J., Jones, D. L., & The COPA Study Group (2025) · International Journal of Behavioral Medicine · doi:10.1007/s12529-025-10356-z · Cited by 3
“Studies assessing the efficacy of interventions for PLWH found that those with a strong focus on alcohol not only reduced alcohol consumption, but also increased adherence and condom use, which may reduce HIV and STD transmission [8].”
A pilot randomized controlled trial of Kisoboka, a behavioral economic and motivational interviewing intervention to reduce high‐risk alcohol use and improve antiretroviral therapy adherence for men in Uganda
Kiene, S. M., Miller, A. P., Ediau, M., Tuhebwe, D., Sileo, K. M., Naigino, R., Hahn, J. A., Reed, E., Anecho, A., Mukasa, B., et al. (2025) · Addiction · doi:10.1111/add.70169 · Cited by 3
Universal HIV Testing and Treatment With Patient-Centered Care Improves ART Uptake and Viral Suppression Among Adults Reporting Hazardous Alcohol Use in Uganda and Kenya
Puryear, S. B., Ayieko, J., Hahn, J. A., Atukunda, M., Owaraganise, A., Schwab, J., Balzer, L. B., Kwarisiima, D., Charlebois, E. D., Cohen, C. R., et al. (2023) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000003226 · Cited by 3
Acceptability, Adaptability, and Feasibility of a Novel Computer-Based Virtual Counselor–Delivered Alcohol Intervention: Focus Group and In-depth Interview Study Among Adults With HIV or Tuberculosis in Indian Clinical Settings
Suryavanshi, N., Dhumal, G., Cox, S. R., Sangle, S. A., DeLuca, A. N., Santre, M., Gupta, A., Chander, G., & Hutton, H. E. (2022) · JMIR Formative Research · doi:10.2196/35835 · Cited by 4
“Moving forward with life’: Perceived acceptability and benefits of a brief alcohol-focused intervention for people receiving antiretroviral therapy in South Africa.Preprint
MYERS, B. J., Parry, C. D. H., Morojele, N. K., Nkosi, S., Shuper, P. A., Kekwaletswe, C. T., & Sorsdahl, K. R. (2020) · doi:10.21203/rs.3.rs-15423/v1 · Cited by 3
The Role of Self-Regulation Strategies in Recovery from Alcohol Use Disorder
Roos, C. R., Bowen, S. W., & Hedy Kober, A. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108976213.007 · Cited by 2
Efficacy of alcohol reduction interventions among people with HIV as evaluated by self-report and a phosphatidylethanol (PEth) outcome: protocol for a systematic review and individual participant data meta-analysis
Kane, J. C., Allen, I. E., Fatch, R., Scheffler, A., Emenyonu, N. I., Puryear, S. B., Chirayil, P., So‐Armah, K., Kahler, C. W., Magidson, J. F., et al. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-070713 · Cited by 2
The Feasibility and Acceptability of a Clinical Pharmacist-delivered Intervention to Reduce Bothersome Health Symptoms from Polypharmacy and Alcohol Use and Communicate Risk among People with HIV: Pilot Study Protocol
Womack, J. A., Leblanc, M. M., Sager, A. S., Zaets, L., Maisto, S. A., Garcia, A., Barakat, L., Brown, S.-E., Edelman, E. J., Fiellin, D. A., et al. (2024) · AIDS and Behavior · doi:10.1007/s10461-024-04533-6 · Cited by 2
“Of particular relevance to the current study, several IMB-based interventions have decreased alcohol use in individuals with HIV [54 ].”
HIV treatment satisfaction: HIVTSQ-12 factor analysis and associated factors in Türkiye
Akbulut, İ., Varol, Z. S., Ödemiş, İ., Eroğul, E., Atalay, S., & Gökengin, A. D. (2024) · BMC Infectious Diseases · doi:10.1186/s12879-024-10251-0 · Cited by 2
Substance Use Classes Among YMSM in an HIV Digital Health Intervention Program: Implications for Acceptability, Engagement, and Health Outcomes
Zapata, J. P., Swann, G., Zamantakis, A., Madkins, K., Danielson, E. C., & Mustanski, B. S. (2025) · AIDS and Behavior · doi:10.1007/s10461-025-04619-9 · Cited by 2
“Our findings align with existing studies, showing that participants with differing substance use profiles at baseline exhibit varied sexual risk behaviors, as well as their impact on follow-up outcomes [6 , 13 ].”
Emerging Viral and Bacterial Infections: Within an Era of Opioid Epidemic
Jones, J. F., Legaspi, J., Chen, E., Lee, K. C., & Lê, J. (2020) · Infectious Diseases and Therapy · doi:10.1007/s40121-020-00335-0 · Cited by 2
Impact of Reduction in Drinking vs. complete Cessation on the Severity and Type of Alcohol-Related Problems in Women Living with HIV
Richards, V. L., Zhou, Z., Wang, Y., Vaddiparti, K., Brumback, B., & Cook, R. L. (2021) · Substance Use & Misuse · doi:10.1080/10826084.2021.1892138 · Cited by 2
Substance Use Disorder and HIV
Slawek, D. E., & Cunningham, C. O. (2020) · Springer eBooks · doi:10.1007/978-3-030-48744-7_10 · Cited by 2
Testing the incremental effectiveness of pay-for-performance to improve implementation of a motivational interviewing brief intervention for substance use disorders in HIV settings: Results of a parallel cluster-randomized type 3 hybrid trialPreprint
Garner, B. R., Tueller, S., Bradshaw, M., Speck, K. J., Satre, D. D., Rash, C. J., Donohoe, T., Mungo, J., Philbrick, S. M., Ruwala, R., et al. (2024) · Research Square · doi:10.21203/rs.3.rs-4614222/v1 · Cited by 2

Authors: The MASH Research Team, Scott-Sheldon, L. A. J., Carey, K. B., Johnson, B. T., & Carey, M. P.
Affiliations: Brown University (US)
University of Connecticut (US)
ORCID: Scott-Sheldon, Lori A. J.
Carey, Kate B.
Johnson, Blair T.
Carey, Michael P.
Venue: AIDS and Behavior
Publisher: Springer Science and Business Media LLC
Published: 2017-08-22
Volume: 21
Issue: S2
Pages: 126-143
ISSN: 1090-7165 (ISSN-L)
1573-3254
DOI: 10.1007/s10461-017-1886-3
PMC: PMC5660648
OpenAlex: W2748537629
Cited by: 133
References: 174
Citations by year: 2026: 5 · 2025: 19 · 2024: 15 · 2023: 22 · 2022: 14 · 2021: 16 · 2020: 20 · 2019: 16 · 2018: 5 · 2017: 1
FWCI: 1.52
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: AIDS and Behavior (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute on Alcohol Abuse and Alcoholism
Topics: Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Keywords: alcohol consumption, people living with HIV, behavioral interventions, alcohol consumption reduction, condom use, medication adherence, viral load, HIV prevention, sexual risk behavior
MeSH terms: Acquired Immunodeficiency Syndrome, Alcohol Drinking, Behavior Therapy, Female, Humans, Male, Sexual Behavior, HIV Infections, Treatment Outcome, Viral Load, Alcohol-Related Disorders, Safe Sex, Medication Adherence

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Behavioral Interventions Targeting Alcohol Use Among People Living with HIV/AIDS: A Systematic Review and Meta-Analysis

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