Cited by 23HIV/AIDS Research and InterventionsMedication Adherence and ComplianceSubstance Abuse Treatment and Outcomes

A conceptual model of alcohol use and adherence to antiretroviral therapy: systematic review and theoretical implications for mechanisms of action

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Woolf-King, Sarah E., Sheinfil, Alan Z., Ramos, Jeremy, Foley, Jacklyn D., Moskal, Dezarie, Firkey, Madison, Kellen, David, Maisto, Stephen A.·2022·Health Psychology Review

Abstract

Alcohol consumption is one of the most prevalent correlates of antiretroviral therapy (ART) adherence, yet causal processes underlying this association remain largely unexplored. The goal of this systematic review was to develop a conceptual model that describes the causal effect of alcohol consumption on ART nonadherence. We reviewed 230 studies that examined the association between alcohol consumption and ART adherence with three primary aims: (1) to replicate and extend previous reviews of the literature, (2) to summarize and critique study designs capable of answering questions about temporal overlap and (3) to summarize potential mechanisms of action. A model of alcohol-associated ART nonadherence was proposed to guide future work, integrating general theories of ART adherence and theory on the psychological and behavioral effects of alcohol intoxication. The conceptual model describes two mechanistic processes-prospective memory impairment and interactive toxicity beliefs/avoidance behaviors-involved in alcohol-associated intentional and unintentional nonadherence, respectively. This model can be used to guide future research on the causal processes involved in the frequently observed correlation between alcohol consumption and adherence.

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Authors
Woolf-King, S. E., Sheinfil, A. Z., Ramos, J., Foley, J. D., Moskal, D., Firkey, M., Kellen, D., & Maisto, S. A.
Affiliations
  • Department of Psychology, Syracuse University, Syracuse, NY, USA
  • Syracuse University (US)
Venue
Health Psychology Review
Published
2020-08-20
Volume
16
Issue
1
Pages
104-133
ISSN
  • 1743-7199 (ISSN-L)
  • 1743-7202
OpenAlex
W3047328158
Cited by
23
References
120
Citations by year
2026: 3 · 2025: 5 · 2024: 2 · 2023: 5 · 2022: 5 · 2021: 3
FWCI
0.15
Type
journal article
Language
en
Open access
Locations
  • Health Psychology Review (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Alcohol Abuse and Alcoholism (K01AA02167, R34AA026246, K05AA016928)
Topics
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
alcohol consumption, antiretroviral therapy adherence, HIV, alcohol intoxication, avoidance behavior, mechanism of action, causal processes, conceptual model
MeSH terms
Alcohol Drinking, Humans, HIV Infections, Anti-HIV Agents, Medication Adherence

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