Awareness of Risk is Not Enough to Decrease Alcohol Use Among People with HIV and Heavy Alcohol Consumption

Although alcohol use has known risks for people with HIV, it is not clear whether those who drink are aware of these risks and change their alcohol use accordingly. In this study, researchers interviewed 254 HIV-infected adults (78% men, 50% black, 45% Latino, 32% co-infected with hepatitis C (HCV), 77% prescribed antiretroviral medication) who had at least 1 instance of heavy episodic drinking (≥ 4 drinks on an occasion for men or ≥ 3 drinks for women) in the past 4 weeks.

• Participants had heavy alcohol use, with averages of > 5 drinks in a drinking day and at least weekly instances of heavy episodic drinking.
• 63% of the total sample and 67% of HIV/HCV co-infected patients were aware they had a medical problem made worse by alcohol use. However, awareness of risk was not associated with decreased alcohol use.
• HIV/HCV co-infected patients were more likely than HIV mono-infected patients to report restriction of alcohol use to avoid a medical problem (72% versus 61%).
• Reported alcohol use was lower—but still well above low-risk levels—among those who reported restriction of alcohol consumption to avoid a medical problem.

Comments:

Awareness of having a medical problem that is exacerbated by alcohol use was not associated with decreased consumption among people with HIV and heavy drinking, many of whom were co-infected with HCV. These findings suggest that education about risk in this population should be followed with behavioral therapy and/or pharmacotherapy.

Kevin L. Kraemer, MD, MSc

Reference:

Elliott JC, Aharonovich E, O’Leary A, et al. Perceived medical risks of drinking, alcohol consumption, and hepatitis C status among heavily drinking HIV primary care patients. Alcohol Clin Exp Res. 2014;38(12):3052–3059.