November 2, 2012
Researchers have shown that about half of HIV patients on antiretroviral therapy skipped their medicines when drinking alcohol. Seth Kalichman, professor at the University of Connecticut, and colleagues investigated how patients' beliefs about drinking and taking medication might contribute to poor treatment adherence. They surveyed 178 patients (four out of five were men) who drank alcohol and were being treated with antiretroviral drugs. The researchers asked participants about their alcohol-related beliefs, and whether people should not take both drugs and alcohol at the same time by avoiding either alcohol or the medicines. Over a year, the team checked with patients every month to determine how well they were adhering to their treatment using a pill count, and every other month they enquired whether the patient had been drinking recently. Doctors' offices provided the patient's level of virus in the body and CD4-cell counts.
Results showed that 51 percent of patients avoided medications when they drank, and half of this group had poor adherence to prescriptions. The half of the group that skipped pills also said they did not take medication until the alcohol is completely out of their system. Of those who reported not skipping their medications when they drank, 36 percent did not adhere well to prescriptions and 31 percent said they did not take medication until the alcohol is out of their system. People who skipped medications while drinking were more likely to have higher levels of HIV in their system and lower numbers of CD4 cells.
The authors concluded that patients living with HIV who deliberately stopped treatment when they are drinking are at risk for treatment failure. Kalichman suggested a simple fix, educating patients about drinking and HIV treatments.
The study titled, Intentional Non-Adherence to Medications among HIV Positive Alcohol Drinkers: Prospective Study of Interactive Toxicity Beliefs, was published online in the Journal of General Internal Medicine (2012, DOI: 10.1007/s11606-012-2231-1).