Cited by 296HIV, Drug Use, Sexual RiskSubstance Abuse Treatment and OutcomesHIV/AIDS Research and Interventions

Alcohol Use and Human Immunodeficiency Virus (HIV) Infection: Current Knowledge, Implications, and Future Directions

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Williams, Emily C., Hahn, Judith A., Saitz, Richard, Bryant, Kendall, Lira, Marlene C., Samet, Jeffrey H.·2016·Alcoholism: Clinical and Experimental Research

Abstract

Alcohol use is common among people living with human immunodeficiency virus (HIV). In this narrative review, we describe literature regarding alcohol's impact on transmission, care, coinfections, and comorbidities that are common among people living with HIV (PLWH), as well as literature regarding interventions to address alcohol use and its influences among PLWH. This narrative review identifies alcohol use as a risk factor for HIV transmission, as well as a factor impacting the clinical manifestations and management of HIV. Alcohol use appears to have additive and potentially synergistic effects on common HIV‐related comorbidities. We find that interventions to modify drinking and improve HIV‐related risks and outcomes have had limited success to date, and we recommend research in several areas. Consistent with Office of AIDS Research/National Institutes of Health priorities, we suggest research to better understand how and at what levels alcohol influences comorbid conditions among PLWH, to elucidate the mechanisms by which alcohol use is impacting comorbidities, and to understand whether decreases in alcohol use improve HIV‐relevant outcomes. This should include studies regarding whether state‐of‐the‐art medications used to treat common coinfections are safe for PLWH who drink alcohol. We recommend that future research among PLWH include validated self‐report measures of alcohol use and/or biological measurements, ideally both. Additionally, subgroup variation in associations should be identified to ensure that the risks of particularly vulnerable populations are understood. This body of research should serve as a foundation for a next generation of intervention studies to address alcohol use from transmission to treatment of HIV. Intervention studies should inform implementation efforts to improve provision of alcohol‐related interventions and treatments for PLWH in healthcare settings. By making further progress on understanding how alcohol use affects PLWH in the era of HIV as a chronic condition, this research should inform how we can mitigate transmission, achieve viral suppression, and avoid exacerbating common comorbidities of HIV and alcohol use and make progress toward the 90‐90‐90 goals for engagement in the HIV treatment cascade.

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  • Since 2008, considerable new scientific evidence has emerged which supports a causal role of alcohol in HIV/AIDS.

    “However, since 2008, considerable new scientific evidence has emerged which supports a causal role of alcohol.”
  • Heavy drinking or alcohol use disorders are associated with viral load increases and/or CD4 count declines, mediated partly by treatment adherence and partly by pharmacological interactions with anti-retroviral and other medications.

    “These include clear evidence that heavy drinking or alcohol use disorders are associated with viral load increases and/or CD4 count declines, mediated partly by treatment adherence and partly by the pharmacological interactions with anti‐retroviral and other medications to treat comorbidities (for mechanisms see 99, 128, 130, 132, 133, 134; for pharmacological interactions see 135, 136).”

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Research works printed but not linked: 3

  1. Azar MM Springer SA Meyer JP A systematic review of the impact of alcohol use disorders on HIV treatment outcomes, adherence to antiretroviral therapy and health care utilization Drug and Alcohol Dependence 2010b 112 178 193 20705402 PMC2997193
  2. Freiberg M Bebu I Tracy R D-dimer doesn’t return to pre-HIV levels after therapy and is linked with HANA events 2015 Conference on Retroviruses and Opportunistic Infections Seattle, WA 240 241
  3. Substance Abuse and Mental Health Services Administration Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings 2014 http://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf 27656739

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Authors
Williams, E. C., Hahn, J. A., Saitz, R., Bryant, K., Lira, M. C., & Samet, J. H.
Affiliations
  • University of Washington (US)
  • University of California, San Francisco (US)
  • Boston University (US)
  • National Institutes of Health (US)
Corresponding author
Samet, Jeffrey H.
Venue
Alcoholism: Clinical and Experimental Research
Publisher
Wiley
Published
2016-09-22
Volume
40
Issue
10
Pages
2056-2072
ISSN
  • 0145-6008 (ISSN-L)
  • 1530-0277
OpenAlex
W2521342226
Cited by
294
References
280
Citations by year
2026: 21 · 2025: 31 · 2024: 21 · 2023: 27 · 2022: 29 · 2021: 37 · 2020: 42 · 2019: 34 · 2018: 24 · 2017: 28
FWCI
3.88
Type
journal article
Language
en
Open access
Locations
  • Alcoholism Clinical and Experimental Research (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Institutes of Health (U01AA020784, U24AA020778, U01AA020780, U01AA020776, K24AA022586)
  • Health Services Research and Development (CDA 12‐276)
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, HIV infection, people living with HIV, HIV transmission, HIV coinfection, HIV comorbidities, alcohol interventions, antiretroviral drug safety, viral suppression, 90-90-90 targets, vulnerable populations
MeSH terms
Alcohol Drinking, Humans, Research, HIV Infections, Comorbidity, Coinfection

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