Longitudinal Association of Alcohol Use With HIV Disease Progression and Psychological Health of Women With HIV

The association of alcohol consumption and depression, and their effects on HIV disease progression among women with HIV, were the subjects of the current study. The participants were 871 HIV-positive women recruited in four U.S. cities between 1993 and 1995.

The participants underwent physical examination, medical record extraction, venipuncture, CD4+ T-cell counts determination, measurement of depression symptoms (using the self-report Center for Epidemiological Studies-Depression Scale), and alcohol use assessment at enrollment and semi-annually until March 2000. Multilevel random co-efficient ordinal models as well as multilevel models with joint responses were used in the analysis.

The results showed no significant association between the level of alcohol use and CD4+ T-cell counts. When subjects were stratified by antiretroviral therapy (ART) use, the association between alcohol and CD4+ T-cell did not reach statistical significance. However, the association between alcohol consumption and depression was significant (p<0.001). Regardless of ART use, depression had a significant negative effect on CD4+ T-cell counts over time.

"Our findings suggest that alcohol consumption has a direct association with depression," the authors concluded. "Moreover, depression is associated with HIV disease progression. Our findings have implications for the provision of alcohol use interventions and psychological resources to improve the health of women with HIV."

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