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Drinking and skipping meds

Nov 3, 2015

I am a 37 y/o male cd4-400+, undetectable 8 years, HIV positive. My question is: I drink heavily once every week. Whiskey drinker here, and every time I drink I opt to skip my pill that 1 night. I've been doing this for a few years now. Is that the reason why my cd 4 never go up? I feel that my cocktails don't really mix with the alcohol. I'm on efevirenz and other stuff.

Response from Dr. Fawcett

Thanks for writing. It is a very dangerous strategy to miss doses of your antiretroviral medication. "Planned nonadherence" is just as problematic as any other reason for missing a dose. It is highly likely that continuing to do so will create a resistance to your medications and your viral load will go up. You don't mention what your current VL is, but this may also account for your CD4s remaining at the same level.

Drinking heavily even once a week qualifies as a binge drinker, and that is a problem. The rule of thumb for someone on HIV medication is one drink per day (and no, you can't "save" them and have them all on one day!). You really need to look into stopping drinking. It is very difficult to cut back (or control) your drinking if you are already a binge drinker. Check out Alcoholics Anonymous or SMART Recovery to see you if can get some help.

Best wishes to you,


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