Current Interventions for People Living with HIV Who Use Alcohol: Why Gender Matters
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Purpose of Review: Alcohol is the most misused substance in the world. For people living with HIV (PLWH), alcohol misuse may impact ART adherence and viral suppression. This review of the most recently published alcohol intervention studies with PLWH examines how these studies considered gender in the samples, design, and analyses. Recent Findings: Three searches were conducted initially, and 13 intervention studies fit our criteria with alcohol outcomes. In general, most studies did not consider gender and had used small samples, and few demonstrated significant efficacy/effectiveness outcomes. Five studies considered gender in their samples or analyses and/or were woman-focused with larger samples and demonstrated significant outcomes. Summary: It is essential for women who misuse alcohol to not only be well represented in alcohol and HIV research but also for studies to consider the barriers to reaching them and their contextual demands and/or co-occurring issues that may affect participation and outcomes in intervention research.
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Randomized clinical trials of alcohol interventions for people with HIV have had mixed success.
“Randomized clinical trials (RCTs) of alcohol interventions for PWH have had mixed success.”
From A Randomized Feasibility/Acceptability Trial of Acceptance and Commitment Therapy for People with HIV Who Drink at Unhealthy Levels. (2026) · cites this paper as [15]
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“18–21 The Sustainable Development Goals (SDG) aims to reduce maternal deaths to less than 70 per 100 000 live births by 2030 (SDG 3.1), neonatal mortality rate to at least as low as 12 per 1000 live births and under-5 mortality rate to at least as low as 25 per 1000 live births (SDG 3.2).”
InfluentialWechsberg, W. M., van der Drift, I. M., Howard, B. N., MYERS, B. J., Browne, F. A., Bonner, C. P., Carney, T., Ndirangu, J., & Washio, Y. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19148661 · Cited by 13 · see citing works
Self-citationBelus, J. M., Joska, J. A., Bronsteyn, Y., Rose, A. L., Andersen, L. S., Regenauer, K. S., MYERS, B. J., Hahn, J. A., Orrell, C., Safren, S. A., et al. (2022) · AIDS and Behavior · doi:10.1007/s10461-022-03765-8 · Cited by 6 · see citing works
“Although preliminary, this is an important contribution to the field given lack of research evaluating gender differences in the effectiveness of interventions that address the intersection of these two epidemics [25].”
BackgroundResultInfluentialGamarel, 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 · see citing works
“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].”
Washio, Y., Browne, F. A., Ndirangu, J., Kline, T. L., & Wechsberg, W. M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18147446 · Cited by 6 · see citing works
Self-citationGasik, R. E., Madkour, A. S., Skeen, S. J., Clum, G. A., Francis, T., Felker-Kantor, E., Ferguson, T. F., Welsh, D. A., Molina, P. E., & Theall, K. P. (2024) · AIDS and Behavior · doi:10.1007/s10461-024-04368-1 · Cited by 2 · see citing works
“[36, 37]).”
Woolf-King, S. E., Dalton, M. R., Firkey, M., Sheinfil, A., Bucci, V., Estrada, B., Ramos, J., Hahn, J. A., Bricker, J., Gump, B., et al. (2026) · AIDS and Behavior · doi:10.1007/s10461-025-04990-7 · Cited by 1 · see citing works
“There have been two meta-analyses [11, 12] and several narrative reviews [13–15] of this literature published over the last decade.”
Gichane, M. W., Camlin, C. S., Getahun, M., Emenyonu, N., Woolf-King, S., Sanyu, N., Katusiime, A., Fatch, R., Muyindike, W., & Hahn, J. A. (2023) · Substance Use & Misuse · doi:10.1080/10826084.2023.2244066 · Cited by 1 · see citing works
Ndirangu, J., Gichane, M. W., Browne, F. A., Bonner, C. P., Zule, W. A., Cox, E. N., Howard, B. N., Kline, T., & Wechsberg, W. M. (2025) · Health Education Research · doi:10.1093/her/cyaf011
Self-citationWoolf‐King, S. E., Presutti, E., McKenna, O., Hahn, J. A., Abar, B. W., Dahne, J., Gump, B. B., Bendinskas, K. G., & Maisto, S. A. (2025) · Contemporary Clinical Trials · doi:10.1016/j.cct.2025.108130
- Authors
- Wechsberg, W. M., Browne, F. A., Bonner, C. P., Washio, Y., Howard, B. N., & van der Drift, I.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- RTI International (US)
- Corresponding author
- Wechsberg, Wendee M.
- Venue
- Current HIV/AIDS Reports
- Published
- 2021-06-10
- Volume
- 18
- Issue
- 4
- Pages
- 351-364
- ISSN
- 1548-3568 (ISSN-L)
- 1548-3576
- PMC
- PMC8190977
- OpenAlex
- W3165962444
- Cited by
- 10
- References
- 86
- Citations by year
- 2025: 3 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 1
- Type
- book review
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Current HIV/AIDS Reports (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion, cc-by)
- UNC Libraries
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01AA022882)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- HIV, alcohol abuse, gender, women, alcohol interventions, antiretroviral therapy adherence, viral suppression, underrepresentation in research, intervention efficacy
- MeSH terms
- Female, Humans, HIV Infections, Medication Adherence
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