Not all non-drinkers with HIV are equal: demographic and clinical comparisons among current non-drinkers with and without a history of prior alcohol use disorders^*

* Data were presented in part at the 38th Annual Research Society on Alcoholism Scientific Meeting, San Antonio, Texas, 6/2015.

ABSTRACT

Studies of persons living with HIV (PLWH) have compared current non-drinkers to at-risk drinkers without differentiating whether current non-drinkers had a prior alcohol use disorder (AUD). The purpose of this study was to compare current non-drinkers with and without a prior AUD on demographic and clinical characteristics to understand the impact of combining them. We included data from six sites across the US from 1/2013 to 3/2015. Patients completed tablet-based clinical assessments at routine clinic appointments using the most recent assessment. Current non-drinkers were identified by AUDIT-C scores of 0. We identified a prior probable AUD by a prior AUD diagnosis in the electronic medical record (EMR) or a report of attendance at alcohol treatment in the clinical assessment. We used multivariate logistic regression to examine factors associated with prior AUD. Among 2235 PLWH who were current non-drinkers, 36% had a prior AUD with more patients with an AUD identified by the clinical assessment than the EMR. Higher proportions with a prior AUD were male, depressed, and reported current drug use compared to non-drinkers without a prior AUD. Former cocaine/crack (70% vs. 25%), methamphetamine/crystal (49% vs. 16%), and opioid/heroin use (35% vs. 7%) were more commonly reported by those with a prior AUD. In adjusted analyses, male sex, past methamphetamine/crystal use, past marijuana use, past opioid/heroin use, past and current cocaine/crack use, and cigarette use were associated with a prior AUD. In conclusion, this study found that among non-drinking PLWH in routine clinical care, 36% had a prior AUD. We found key differences between those with and without prior AUD in demographic and clinical characteristics, including drug use and depression. These results suggest that non-drinkers are heterogeneous and need further differentiation in studies and that prior alcohol misuse (including alcohol treatment) should be included in behavioural health assessments as part of clinical care.

KEYWORDS:

• HIV
• alcohol use
• substance use
• alcohol use disorders
• adherence

Acknowledgements

We thank the patients and providers throughout the CNICS network.

Notes

* Data were presented in part at the 38th Annual Research Society on Alcoholism Scientific Meeting, San Antonio, Texas, 6/2015.

Additional information

Funding

This work was supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) at the National Institutes of Health under Grants U24AA020801, U01AA020793, and U01AA020802; the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health under Grants R24AI067039, P30AI027757, P30AI50410, and P30AI27767.