Hazardous alcohol use, antiretroviral therapy receipt, and viral suppression in people living with HIV who inject drugs in the United States, India, Russia, and Vietnam

Jennifer A. Wagman; Adrian Wynn; Mika Matsuzaki; Natalia Gnatienko; Lisa R Metsch; Carlos del Rio; Daniel J. Feaster; Robin M Nance; Bridget M Whitney; Joseph A.C. Delaney; Shoshana Y Kahana; Heidi M Crane; Redonna K. Chandler; Jennifer C Elliott

doi:10.1097/QAD.0000000000002716

Hazardous alcohol use, antiretroviral therapy receipt, and viral suppression in people living with HIV who inject drugs in the United States, India, Russia, and Vietnam

Jennifer A. Wagman, Adrian Wynn, Mika Matsuzaki, Natalia Gnatienko, Lisa R Metsch, Carlos del Rio, Daniel J. Feaster, Robin M Nance, Bridget M Whitney, Joseph A.C. Delaney, Shoshana Y Kahana, Heidi M Crane, Redonna K. Chandler, Jennifer C Elliott

Psychology

Research & Scholarship: Contribution to journal › Article › peer-review

Abstract

 Additional Authors: Frederick Altice
 UCLA Fielding School of Public Health
 Gregory M. Lucas
 UCLA Fielding School of Public Health
 Shruti H. Mehta
 UCLA Fielding School of Public Health
 Yael Hirsch-Moverman
 UCLA Fielding School of Public Health
 Wafaa M. El-Sadr
 UCLA Fielding School of Public Health
 Quan Vu
 UCLA Fielding School of Public Health
 Binh Nguyen Thanh
 UCLA Fielding School of Public Health
 Sandra A. Springer
 UCLA Fielding School of Public Health
 Judith I. Tsui
 UCLA Fielding School of Public Health
 Jeffrey H. Samet
 UCLA Fielding School of Public Health
 
 Objectives:
 In high-income countries, hazardous alcohol use is associated with reduced receipt of antiretroviral therapy (ART) and viral suppression among people living with HIV (PLHIV) who inject drugs. These associations are less understood in lower middle-income countries (LMIC) and upper middle-income countries.
 Design:
 We examined associations between hazardous alcohol use, ART receipt, and viral suppression among PLHIV who reported current or former injection drug use. Participants were from nine studies in the United States (high-income country), India (LMIC), Russia (upper middle-income country), and Vietnam (LMIC).
 Methods:
 Hazardous alcohol use was measured via Alcohol Use Disorders Identification Test. Outcomes were HIV viral suppression (viral load of <1000 RNA copies/ml) and self-reported ART receipt. Logistic regression assessed associations between hazardous alcohol use and both outcome variables, controlling for age and sex, among participants with current and former injection drug use.
 Results:
 Among 2790 participants, 16% were women, mean age was 37.1 ± 9.5 years. Mean Alcohol Use Disorders Identification Test scores were 4.6 ± 8.1 (women) and 6.2 ± 8.3 (men); 42% reported ART receipt; 40% had viral suppression. Hazardous alcohol use was significantly associated with reduced ART receipt in India (adjusted odds ratio = 0.59, 95% confidence interval: 0.45–0.77,    P   < 0.001); and lower rates of viral suppression in Vietnam (adjusted odds ratio = 0.51, 95% confidence interval: 0.31–0.82,    P   = 0.006).
 Conclusion:
 Associations between hazardous alcohol use, ART receipt, and viral suppression varied across settings and were strongest in LMICs. Addressing hazardous alcohol use holds promise for improving HIV continuum of care outcomes among PLHIV who inject drugs. Specific impact and intervention needs may differ by setting.

Original language	English
Pages (from-to)	2285-2294
Number of pages	10
Journal	AIDS
Volume	34
Issue number	15
DOIs	https://doi.org/10.1097/QAD.0000000000002716
State	Published - Dec 1 2020

ASJC Scopus Subject Areas

Immunology and Allergy
Immunology
Infectious Diseases

Keywords

Antiretroviral receipt
HIV infection
Hazardous alcohol use
High-income country
Middle-income country
People living with HIV
People who inject drugs
Viral suppression

Access to Document

10.1097/QAD.0000000000002716

Cite this

Wagman, J. A., Wynn, A., Matsuzaki, M., Gnatienko, N., Metsch, L. R., del Rio, C., Feaster, D. J., Nance, R. M., Whitney, B. M., Delaney, J. A. C., Kahana, S. Y., Crane, H. M., Chandler, R. K., & Elliott, J. C. (2020). Hazardous alcohol use, antiretroviral therapy receipt, and viral suppression in people living with HIV who inject drugs in the United States, India, Russia, and Vietnam. AIDS, 34(15), 2285-2294. https://doi.org/10.1097/QAD.0000000000002716

Wagman, JA, Wynn, A, Matsuzaki, M, Gnatienko, N, Metsch, LR, del Rio, C, Feaster, DJ, Nance, RM, Whitney, BM, Delaney, JAC, Kahana, SY, Crane, HM, Chandler, RK & Elliott, JC 2020, 'Hazardous alcohol use, antiretroviral therapy receipt, and viral suppression in people living with HIV who inject drugs in the United States, India, Russia, and Vietnam', AIDS, vol. 34, no. 15, pp. 2285-2294. https://doi.org/10.1097/QAD.0000000000002716

@article{6e41e51de3fd4682a46cfa8a98b7d030,

title = "Hazardous alcohol use, antiretroviral therapy receipt, and viral suppression in people living with HIV who inject drugs in the United States, India, Russia, and Vietnam",

abstract = " Additional Authors: Frederick Altice UCLA Fielding School of Public Health Gregory M. Lucas UCLA Fielding School of Public Health Shruti H. Mehta UCLA Fielding School of Public Health Yael Hirsch-Moverman UCLA Fielding School of Public Health Wafaa M. El-Sadr UCLA Fielding School of Public Health Quan Vu UCLA Fielding School of Public Health Binh Nguyen Thanh UCLA Fielding School of Public Health Sandra A. Springer UCLA Fielding School of Public Health Judith I. Tsui UCLA Fielding School of Public Health Jeffrey H. Samet UCLA Fielding School of Public Health Objectives: In high-income countries, hazardous alcohol use is associated with reduced receipt of antiretroviral therapy (ART) and viral suppression among people living with HIV (PLHIV) who inject drugs. These associations are less understood in lower middle-income countries (LMIC) and upper middle-income countries. Design: We examined associations between hazardous alcohol use, ART receipt, and viral suppression among PLHIV who reported current or former injection drug use. Participants were from nine studies in the United States (high-income country), India (LMIC), Russia (upper middle-income country), and Vietnam (LMIC). Methods: Hazardous alcohol use was measured via Alcohol Use Disorders Identification Test. Outcomes were HIV viral suppression (viral load of <1000 RNA copies/ml) and self-reported ART receipt. Logistic regression assessed associations between hazardous alcohol use and both outcome variables, controlling for age and sex, among participants with current and former injection drug use. Results: Among 2790 participants, 16% were women, mean age was 37.1 ± 9.5 years. Mean Alcohol Use Disorders Identification Test scores were 4.6 ± 8.1 (women) and 6.2 ± 8.3 (men); 42% reported ART receipt; 40% had viral suppression. Hazardous alcohol use was significantly associated with reduced ART receipt in India (adjusted odds ratio = 0.59, 95% confidence interval: 0.45–0.77, P < 0.001); and lower rates of viral suppression in Vietnam (adjusted odds ratio = 0.51, 95% confidence interval: 0.31–0.82, P = 0.006). Conclusion: Associations between hazardous alcohol use, ART receipt, and viral suppression varied across settings and were strongest in LMICs. Addressing hazardous alcohol use holds promise for improving HIV continuum of care outcomes among PLHIV who inject drugs. Specific impact and intervention needs may differ by setting.",

keywords = "Antiretroviral receipt, HIV infection, Hazardous alcohol use, High-income country, Middle-income country, People living with HIV, People who inject drugs, Viral suppression",

author = "Wagman, {Jennifer A.} and Adrian Wynn and Mika Matsuzaki and Natalia Gnatienko and Metsch, {Lisa R} and {del Rio}, Carlos and Feaster, {Daniel J.} and Nance, {Robin M} and Whitney, {Bridget M} and Delaney, {Joseph A.C.} and Kahana, {Shoshana Y} and Crane, {Heidi M} and Chandler, {Redonna K.} and Elliott, {Jennifer C}",

year = "2020",

month = dec,

day = "1",

doi = "10.1097/QAD.0000000000002716",

language = "English",

volume = "34",

pages = "2285--2294",

journal = "AIDS",

issn = "0269-9370",

publisher = "Lippincott Williams & Wilkins",

number = "15",

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TY - JOUR

T1 - Hazardous alcohol use, antiretroviral therapy receipt, and viral suppression in people living with HIV who inject drugs in the United States, India, Russia, and Vietnam

AU - Wagman, Jennifer A.

AU - Wynn, Adrian

AU - Matsuzaki, Mika

AU - Gnatienko, Natalia

AU - Metsch, Lisa R

AU - del Rio, Carlos

AU - Feaster, Daniel J.

AU - Nance, Robin M

AU - Whitney, Bridget M

AU - Delaney, Joseph A.C.

AU - Kahana, Shoshana Y

AU - Crane, Heidi M

AU - Chandler, Redonna K.

AU - Elliott, Jennifer C

PY - 2020/12/1

Y1 - 2020/12/1

N2 - Additional Authors: Frederick Altice UCLA Fielding School of Public Health Gregory M. Lucas UCLA Fielding School of Public Health Shruti H. Mehta UCLA Fielding School of Public Health Yael Hirsch-Moverman UCLA Fielding School of Public Health Wafaa M. El-Sadr UCLA Fielding School of Public Health Quan Vu UCLA Fielding School of Public Health Binh Nguyen Thanh UCLA Fielding School of Public Health Sandra A. Springer UCLA Fielding School of Public Health Judith I. Tsui UCLA Fielding School of Public Health Jeffrey H. Samet UCLA Fielding School of Public Health Objectives: In high-income countries, hazardous alcohol use is associated with reduced receipt of antiretroviral therapy (ART) and viral suppression among people living with HIV (PLHIV) who inject drugs. These associations are less understood in lower middle-income countries (LMIC) and upper middle-income countries. Design: We examined associations between hazardous alcohol use, ART receipt, and viral suppression among PLHIV who reported current or former injection drug use. Participants were from nine studies in the United States (high-income country), India (LMIC), Russia (upper middle-income country), and Vietnam (LMIC). Methods: Hazardous alcohol use was measured via Alcohol Use Disorders Identification Test. Outcomes were HIV viral suppression (viral load of <1000 RNA copies/ml) and self-reported ART receipt. Logistic regression assessed associations between hazardous alcohol use and both outcome variables, controlling for age and sex, among participants with current and former injection drug use. Results: Among 2790 participants, 16% were women, mean age was 37.1 ± 9.5 years. Mean Alcohol Use Disorders Identification Test scores were 4.6 ± 8.1 (women) and 6.2 ± 8.3 (men); 42% reported ART receipt; 40% had viral suppression. Hazardous alcohol use was significantly associated with reduced ART receipt in India (adjusted odds ratio = 0.59, 95% confidence interval: 0.45–0.77, P < 0.001); and lower rates of viral suppression in Vietnam (adjusted odds ratio = 0.51, 95% confidence interval: 0.31–0.82, P = 0.006). Conclusion: Associations between hazardous alcohol use, ART receipt, and viral suppression varied across settings and were strongest in LMICs. Addressing hazardous alcohol use holds promise for improving HIV continuum of care outcomes among PLHIV who inject drugs. Specific impact and intervention needs may differ by setting.

AB - Additional Authors: Frederick Altice UCLA Fielding School of Public Health Gregory M. Lucas UCLA Fielding School of Public Health Shruti H. Mehta UCLA Fielding School of Public Health Yael Hirsch-Moverman UCLA Fielding School of Public Health Wafaa M. El-Sadr UCLA Fielding School of Public Health Quan Vu UCLA Fielding School of Public Health Binh Nguyen Thanh UCLA Fielding School of Public Health Sandra A. Springer UCLA Fielding School of Public Health Judith I. Tsui UCLA Fielding School of Public Health Jeffrey H. Samet UCLA Fielding School of Public Health Objectives: In high-income countries, hazardous alcohol use is associated with reduced receipt of antiretroviral therapy (ART) and viral suppression among people living with HIV (PLHIV) who inject drugs. These associations are less understood in lower middle-income countries (LMIC) and upper middle-income countries. Design: We examined associations between hazardous alcohol use, ART receipt, and viral suppression among PLHIV who reported current or former injection drug use. Participants were from nine studies in the United States (high-income country), India (LMIC), Russia (upper middle-income country), and Vietnam (LMIC). Methods: Hazardous alcohol use was measured via Alcohol Use Disorders Identification Test. Outcomes were HIV viral suppression (viral load of <1000 RNA copies/ml) and self-reported ART receipt. Logistic regression assessed associations between hazardous alcohol use and both outcome variables, controlling for age and sex, among participants with current and former injection drug use. Results: Among 2790 participants, 16% were women, mean age was 37.1 ± 9.5 years. Mean Alcohol Use Disorders Identification Test scores were 4.6 ± 8.1 (women) and 6.2 ± 8.3 (men); 42% reported ART receipt; 40% had viral suppression. Hazardous alcohol use was significantly associated with reduced ART receipt in India (adjusted odds ratio = 0.59, 95% confidence interval: 0.45–0.77, P < 0.001); and lower rates of viral suppression in Vietnam (adjusted odds ratio = 0.51, 95% confidence interval: 0.31–0.82, P = 0.006). Conclusion: Associations between hazardous alcohol use, ART receipt, and viral suppression varied across settings and were strongest in LMICs. Addressing hazardous alcohol use holds promise for improving HIV continuum of care outcomes among PLHIV who inject drugs. Specific impact and intervention needs may differ by setting.

KW - Antiretroviral receipt

KW - HIV infection

KW - Hazardous alcohol use

KW - High-income country

KW - Middle-income country

KW - People living with HIV

KW - People who inject drugs

KW - Viral suppression

U2 - 10.1097/QAD.0000000000002716

DO - 10.1097/QAD.0000000000002716

M3 - Article

SN - 0269-9370

VL - 34

SP - 2285

EP - 2294

JO - AIDS

JF - AIDS

IS - 15

ER -