Patient/Physician Discussion of Alcohol Use Is Low among HIV-infected Patients with Problem Drinking
To develop effective interventions addressing alcohol use disorders in the HIV primary care setting, it is necessary to understand the frequency and extent of patient/provider discussions of alcohol use. In a cross-sectional study, researchers analyzed data from 1225 HIV-positive patients attending 10 HIV primary care clinics in 3 US cities to determine the extent to which alcohol use was discussed with their primary care providers.
More than half (57.6%) of respondents reported using alcohol in the past 6 months: 25.3% reported using it less than 1 day per week, 18% reported using it 1-2 days per week, 10% reported using it 3-6 days per week, and 4.3% reported using it about every day. Based on CAGE responses, 22% of respondents had problem drinking, one-third drank without problems, and the remainder did not drink.
- Respondents discussed alcohol use most frequently with their primary care providers (35.3%), followed by other professionals (18.4%) and support groups (17.8%).
- Rates of alcohol discussion increased from nondrinkers (24%), to patients without problem drinking (39%), to patients with problem drinking (52%). In multivariable analysis, those who drank alcohol (with and without alcohol problems) were more likely to discuss alcohol use with their primary care provider than nondrinkers.
- In addition to drinking behavior, other factors independently associated with discussing alcohol use included male sex, age younger than 40 years, non-Hispanic ethnicity, better perception of engagement with the HIV provider, and worse self-reported general health status.
Although patients with problem drinking were more likely to discuss alcohol use with their primary care providers than nondrinkers, only half of such patients reported adiscussion. These findings reinforce the need to increase the focus on alcohol use in the HIV primary care setting. Although HIV primary care providers are faced with many demands, they should be encouraged to screen for and counsel patients about alcohol use.Julia H. Arnsten, MD, MPH
Metsch LR, Pereyra M, Colfax G, et al. HIV-positive patients' discussion of alcohol use with their HIV primary care providers. Drug Alcohol Depend. 2008;95(1–2):37–44.