University of California, San Francisco, United States; San Francisco Department of Public Health, United States.
University of California, San Francisco, United States.
Drug Alcohol Depend. 2014 Jan 1;134:151-157. doi: 10.1016/j.drugalcdep.2013.09.025. Epub 2013 Oct 5.
There is limited data on the impact of anti-retroviral treatment (ART) initiation on alcohol consumption. We characterized predictors of abstaining from alcohol among HIV-infected individuals following ART initiation.
We analyzed data from a prospective cohort of HIV-infected adults in Mbarara, Uganda with quarterly measures of self-reported alcohol consumption, socio-demographics, health status, and blood draws. We used pooled logistic regression to evaluate predictors of becoming abstinent from alcohol for at least 90 days after baseline.
Among the 502 participants, 108 (21.5%) were current drinkers who consumed alcohol within 90 days of baseline, 206 (41.0%) were former drinkers, and 188 (37.5%) were lifetime abstainers at baseline. Among current drinkers, 67 (62.0%) drank at hazardous levels. 90 of current drinkers (83.3%) abstained from alcohol at least for 90 days over 3.6 median years of follow-up [IQR 2-4.8]; of those 69 (76.7%) remained abstinent for a median duration of follow-up of 3.25 years [1.6-4.5]. Becoming abstinent was independently associated with lower baseline AUDIT score (adjusted odds ratio [AOR] 0.95 [95%CI 0.91-0.99]), baseline physical health score (AOR 0.92 [0.87-0.97]), and decreases in physical health score at follow-up visits (AOR 0.92 [0.88-0.97)). Alcohol abstinence was most likely to start immediately after ART initiation (AORs for 6 month versus 3 month visit: 0.25 [0.10-0.61]; 9 month visit or later versus 3 month visit: 0.04 [0.02-0.09]).
We found that a large majority of drinkers starting ART reported that they became and remained abstinent from alcohol. ART initiation may be an opportune time to implement interventions for alcohol consumption and other health behaviors.
目前关于抗逆转录病毒治疗（ART）启动对饮酒的影响的数据有限。我们描述了 HIV 感染者在开始接受 ART 后戒酒的预测因素。
我们分析了乌干达姆巴拉拉前瞻性队列中 HIV 感染成年人的数据，每季度测量一次自我报告的饮酒量、社会人口统计学、健康状况和血液检测。我们使用汇总逻辑回归评估了在基线后至少 90 天内成为戒酒者的预测因素。
在 502 名参与者中，108 名（21.5%）是当前饮酒者，即在基线前 90 天内饮酒，206 名（41.0%）是既往饮酒者，188 名（37.5%）是终生戒酒者。在当前饮酒者中，67 名（62.0%）饮酒达到危险水平。在 3.6 年的中位随访中，90 名当前饮酒者（83.3%）至少戒酒 90 天[IQR 2-4.8]；其中 69 名（76.7%）在中位随访 3.25 年内保持戒酒[1.6-4.5]。戒酒与基线 AUDIT 评分较低（调整后的优势比 [AOR] 0.95 [95%CI 0.91-0.99]）、基线身体健康评分（AOR 0.92 [0.87-0.97]）和随访期间身体健康评分下降独立相关（AOR 0.92 [0.88-0.97]）。戒酒最有可能在开始接受 ART 后立即开始（6 个月与 3 个月就诊时的 AOR 为 0.25 [0.10-0.61]；9 个月就诊或更晚与 3 个月就诊时的 AOR 为 0.04 [0.02-0.09]）。
我们发现，大多数开始接受 ART 的饮酒者报告说他们已经戒酒并保持了一段时间。ART 启动可能是实施干预饮酒和其他健康行为的最佳时机。
