Expanding Research on the Role of Alcohol Consumption and Related Risks in the Prevention and Treatment of HIV_AIDS

Abstract

This article is a review of some of the major epidemiological, behavioral, biological, and integrative prevention research issues and priorities in the area of HIV_AIDS and alcohol consumption. Drinking alcohol increases both the risk for infection with HIV and related illnesses and the morbidity and mortality of patients who progress to AIDS. New and improved measurement procedures have helped in assessment of the complex patterns of alcohol use, identification of intervening explanatory mechanisms for risk behaviors and contexts, and determination of intervention outcomes. Both the direct and indirect effects of alcohol misuse appear to be major contributors to both the risk for infection with HIV and the transmission of HIV_AIDS at the individual and population levels. There is increasing evidence that perhaps no level of alcohol consumption is “safe” for those who are HIV infected and receiving antiretroviral treatment. Interdisciplinary basic behavioral and biomedical research is needed to develop comprehensive culturally appropriate strategies for programs that can be effectively delivered in community contexts in the United States and abroad and that focus on the integration of our understanding of individual behaviors, high-risk group membership, biological mechanisms, and the social and physical environments that place individuals at risk for HIV infection. High-priority topics include improving adherence to antiretroviral medications, prevention of infection in young minority women in the United States, and treatment of HIV+ pregnant women who are alcohol abusers to prevent adverse fetal outcomes, which is an international focus in under-resourced settings in Africa.

Keywords:

• AIDS
• alcohol consumption
• alcohol misuse
• at risk
• behavior
• CNS
• HIV
• immune

Notes

The journal's style utilizes the category substance abuse as a diagostic category. Substances are used or misusesd; living organisms are and can be abused. Editor's note.

The terminology is intended to refer to an empirically driven category without reference to any stereotypes embedded in this terminology. The creation of any taxonomy is a function of the characteristics of criteria used as well as the perspective of the categorizer. In this case we do not mean to create a new diagnostic taxonomy but rather to refer to a particular adaptational life style. These conditions are neither as predictable nor as controllable as intervention agents and other stakeholders tend to believe and communicate, despite evidence cited by the well-documented “natural recovery” literature (Klingemann and Sobell, 2001).

Such dimensions include the following: a relationship dimension; a personal development dimension; maintenance and change dimensions; emotional catalyzer dimensions; information catalyzer and processing dimensions; environmental perceptions, attitudes, and values dimensions; problem-solving_adaptational dimensions; and dimension definer-boundary definer (Tuan, 1972; Winters et al., 1974).

For a more complete discussion see http://www.niaaa.nih.gov/publications/arh25-4/288-298-text.htm