Intersecting alcohol use and depression impedes HIV treatment in the rural South, USA

Abstract

This study tested the hypothesis that the co-occurrence of alcohol use and depressive symptoms predicts HIV suppression and antiretroviral therapy (ART) adherence among people living with HIV. Baseline cross-sectional results showed a significant interaction between depressive symptoms and alcohol use in predicting HIV suppression; individuals who drank more alcohol and had higher depressive symptoms demonstrated poorer HIV suppression relative to those who had fewer depressive symptoms. In a one-year longitudinal analysis of ART adherence, alcohol use and depressive symptoms measured in daily text-message assessments demonstrated that neither alcohol use nor depressive symptoms alone predicted ART adherence. However, the intersection of alcohol use on days when experiencing depressive symptoms did significantly predict ART non-adherence, for both moderate and heavy alcohol drinkers. Findings suggest that the co-occurrence of alcohol use and depressive symptoms is a robust predictor of poor HIV treatment outcomes.

Keywords:

• alcohol use
• depression
• HIV treatment
• medication adherence

Human subjects approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

The study was approved by the University of Connecticut Institutional Review Board Protocol H14-184GDPH and all participants gave written informed consent.

Written informed consent was obtained from all participants included in this study.

Additional information

Funding

This project was supported by National Institute of Alcohol Abuse and Alcoholism Grant R01-AA023727.