Effect of Heavy Alcohol Use on Self-Reported Health Status in Men vs Women With HIV

Heavy alcohol use in women with HIV infection was associated with lower self-reported health status scores, according to results of a longitudinal cohort study published in the American Journal of Medicine Open.

Investigators obtained data captured from patients with HIV infection engaged in care across 7 clinics that were participating in the Centers for AIDS Research Network of Integrated Care Systems. Eligible patients included those who were evaluated at a clinic at least twice and had completed assessments on self-reported alcohol use and health status between January 2011 and June 2014. Alcohol use was assessed via the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) questionnaire at the index visit, and health status was assessed between 3.5 and 18 months later via the EuroQol-5 Dimension questionnaire. Quantile regression was used to assess the distribution of self-reported health status scores across 3 patient groups: women, men who have sex with women (MSW), and men who have sex with men (MSM). The investigators also conducted a sensitivity analysis to determine whether there was an interaction between alcohol use and self-reported symptoms of depression.

There were a total of 5046 patients included in the analysis, of whom 668 were women, 978 were MSW, and 3400 were MSM. Among women, 56% were Black and the median age was 45 (IQR, 37-52) years. Among MSW, 46% were White and the median age was 45 (IQR, 37-51) years. Among MSM, 59% were White and the median age was 44 (IQR, 36-50) years. At the index visit, heavy alcohol use was reported by 21% of women, 31% of MSW, and 37% of MSM, and baseline symptoms of depression were reported by 20% of women, 23% of MSW, and 22% of MSM.

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For women, median health status scores were decreased among those who reported heavy alcohol use compared with those who reported either no or moderate alcohol use (odds ratio [OR], 0.76; 95% CI, 0.58-0.99). The association between alcohol use and decreased health status scores in women was not explained by the presence of depressive symptoms in the sensitivity analysis. Of note, median health status scores were decreased among MSM who reported no alcohol use compared with those who reported moderate alcohol use (OR, 0.88; 95% CI, 0.80-0.97).

There was no significant association between alcohol use and self-reported health status noted among MSW.

This study was limited by the inability to assess the effect of medical and psychiatric comorbidities on self-reported alcohol use and health status scores, and patients’ alcohol use may have changed between the index visit and the time at which health status scores were obtained.

“Incorporating screening for alcohol use and alcohol use disorders should be a routine component of HIV care to identify patients who could benefit from further interventions [and] treatment,” the investigators concluded.

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. Published online June 28, 2022. doi:10.1016/j.ajmo.2022.100020