Heavy Alcohol Use Associated With Lower Self-Reported Health Status in Women With HIV

Heavy alcohol use in women with HIV was found to be associated with lower self-reported health status, whereas this association was not seen in men with HIV, according to a study published in the American Journal of Medicine Open. Identifying patients with high alcohol use could help enable further interventions, treatment, and improved outcomes.

Poor health outcomes have been associated with alcohol use in HIV, and the prevalence of alcohol use disorder has been estimated at 31% of people with HIV, higher than the 6% prevalence in the general population. The relationship between alcohol use and self-reported health status has been unclear in the past. This study aimed to determine the effect of alcohol on self-reported health status in women, men who have sex with women (MSW), and men who have sex with men (MSM) who are living with HIV and engaged in HIV care.

The study used the Centers for AIDS Research network of Integrated Clinical Systems cohort for the study, which collects data from 8 locations in the United States. Data from 7 of these clinics were included, with data coming from Fenway Community Health Center in Boston, Johns Hopkins University in Baltimore, University of Alabama at Birmingham, University of California in San Diego, University of California in San Francisco, University of North Carolina in Chapel Hill, and the University of Washington in Seattle.

Patients included were those who had 2 or more clinic visits and self-reported outcome assessments completed between January 2011 and June 2014. The participant’s recent exposure to alcohol was an exposure. The participant self-reported outcomes assessment included Alcohol Use Disorders identification Test-Consumption questions. The questions assessed heavy alcohol use within the past year. All participants reported their overall perceived health status from 0 (worst) to 100 (best).

A total of 13,111 person-periods were used for this study, of which 668 were women, 978 were MSW, and 3400 were MSM, for a total of 5046 participants. There was a median of 2 person-periods per person and there was a median length of time between visits of 8.4 months. A total of 56% of female participants were Black and the women had a median age of 45 years. MSW were primarily White (46%) and they had a median age of 45 years. The majority of MSM were also White (59%) and had a median age of 44 years. Prevalence of alcohol use at the first assessment was 21%, 31%, and 37% in women, MSW, and MSM, respectively.

Women who had heavy alcohol use were found to have lower self-reported health status scores compared with women without alcohol use or with moderate alcohol use (odds ratio [OR], 0.76; 95% CI, 0.58-0.99). The median self-reported health status score in women with heavy alcohol use was found to be 5 points lower compared with women with moderate alcohol use.

Self-reported health status score distributions in MSW was found to have no significant difference by alcohol use. Point estimates for MSW with heavy alcohol use were lower than for MSW with moderate alcohol use, but there was a lack of precision in the estimate.

MSM had lower self-reported health status scores if they had no alcohol use when compared with MSM with moderate alcohol use (OR, 0.88; 95% CI, 0.80-0.97).

There were some limitations to this study. Alcohol use was assessed using the scores from the database, which do not account for nuance in drinking patterns. The single measure of self-reported health status didn’t allow for assessing which domain was the most affected in each participant. Also, the burden of medical and psychiatric comorbidities could not be accounted for.

The researchers concluded that heavy alcohol use was associated with lower self-reported health status in women with HIV.

Reference

Pytell JD, Li X, Thompson C, et al. The temporal relationship of alcohol use and subsequent self-reported health status among people with HIV. Am J Med Open. 2023;9:100020. doi:10.1016/j.ajmo.2022.100020