Predictive Utility of Brief Alcohol Use Disorders Identification Test (AUDIT) for Human Immunodeficiency Virus Antiretroviral Medication Nonadherence

ABSTRACT

Alcohol use negatively affects adherence to antiretroviral therapy (ART), thus human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) care providers need accurate, efficient assessments of alcohol use. Using existing data from an efficacy trial of 2 cognitive-behavioral ART adherence interventions, the authors sought to determine if results on 2 common alcohol screening tests (Alcohol Use Disorders Identification Test—Consumption [AUDIT-C] and its binge-related question [AUDIT-3]) predict ART nonadherence. Twenty-seven percent of the sample (n = 308) were positive on the AUDIT-C and 34% were positive on the AUDIT-3. In multivariate analyses, AUDIT-C–positive status predicted ART nonadherence after controlling for race, age, conscientiousness, and self-efficacy (P = .036). Although AUDIT-3–positive status was associated with ART nonadherence in unadjusted analyses, this relationship was not maintained in the final multivariate model. The AUDIT-C shows potential as an indirect screening tool for both at-risk drinking and ART nonadherence, underscoring the relationship between alcohol and chronic disease management.

KEYWORDS:

• Acquired immunodeficiency syndrome
• alcohol consumption
• HIV infection
• mass screening
• patient adherence

Acknowledgments

This study was financially supported by a Ruth L. Kirschstein National Research Service Award (NRSA) to Dr. Broyles from the National Institute of Nursing Research (NINR, F31NR008822) and by NINR grant no. R01NR004749 to Dr. Erlen. Dr. Broyles is currently supported by a Career Development Award (CDA) from the Health Services Research & Development Service of the US Department of Veterans Affairs. The material is the result of work supported with resources and the use of facilities at the VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.

The authors gratefully acknowledge the editorial contributions of Dr. Kevin L. Kraemer, University of Pittsburgh School of Medicine, and the data management contributions of Ms. Lisa Tamres and Mr. Blair Powell at the University of Pittsburgh School of Nursing.

A preliminary version of these results were presented as an oral paper presentation at the Association for Medical Education and Research in Substance Abuse (AMERSA) Annual Conference, Bethesda, Maryland, November 5–7, 2009.