Hello Doctor,

I am the spouse of an HIV- positive man. He was diagnosed positive about 6 years ago. All his lab values come back normal each visit. However, my husband drinks every day, darn near all day. When I say anything he always tells me that other guy's wives don't complain about what their husbands do. I am not only afraid of the damage to him, but worried about me as well. How bad, if at all, is it for him to drink so much on meds?

Thanks for writing. Most professionals agree that moderate drinking (one alcoholic drink per day) isn't harmful for someone on HIV medications. It sounds as if your husband, however, far exceeds that amount. Anyone who drinks every day, and all day, needs to examine the fact that they are drinking alcoholically. His anger about you pointing it out is typical and characteristic of denial, a symptom of addiction. While alcohol doesn't necessarily interact with HIV medications like some other recreational drugs, they both get processed by the liver. Since HIV medications and alcohol both strain the liver, at some point your husband's lab values will be affected.

Your husband needs to get his drinking under control. It is generally accepted that someone who drinks at alcoholic levels needs to abstain; "controlling" the drinking is no longer an option. He can find help at Alcoholics Anonymous or SMART Recovery. I strongly recommend that you seek help for yourself as well because, as you note, you are also being affected. Check out Al-Anon for support.

Good luck to you both,

David