期刊
AIDS AND BEHAVIOR
卷 23, 期 1, 页码 140-151出版社
SPRINGER/PLENUM PUBLISHERS
DOI: 10.1007/s10461-018-2210-6
关键词
HIV; Care continuum; Treatment cascade; Antiretroviral therapy; Viral suppression; Alcohol
资金
- National Institute on Alcohol Abuse and Alcoholism [K24-AA022128, R21AA022866-01]
- VA Health Services Research Development [CDA 12-276]
- COMpAAAS/Veterans Aging Cohort Study [U24-AA020794, U01-AA020790, U01-AA020795, U01-AA020799, U10 AA013566]
We evaluated associations between levels of alcohol use and HIV care continuum components using national Veterans Aging Cohort Study data for all patients with HIV and AUDIT-C screening (2/1/2008-9/30/2014). Poisson regression models evaluated associations between alcohol use levels (non-drinking, low-, medium-, high-, and very high-level drinking) and: (1) engagement with care (documented CD4 cells/mu l or viral load copies/ml labs), (2) ART treatment (1 prescription), and (3) viral suppression (HIV RNA<500 copies/ml) within one year. Among 33,224 patients, alcohol use level was inversely associated with all care continuum outcomes (all p<0.001). Adjusted prevalence of care engagement ranged from 77.8% (95% CI 77.1-78.4%) for non-drinking to 69.1% (66.6-71.6%) for high-level drinking. The corresponding range for ART treatment was 74.0% (73.3-74.7%) to 60.1% (57.3-62.9%) and for viral suppression was 57.3% (56.5-58.1%) to 38.3% (35.6-41.1%). Greater alcohol use is associated with suboptimal HIV treatment across the HIV care continuum.
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