Alcohol use negatively affects adherence to antiretroviral therapy (ART), thus human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) care providers need accurate, efficient assessments of alcohol use. Using existing data from an efficacy trial of 2 cognitive-behavioral ART adherence interventions, the authors sought to determine if results on 2 common alcohol screening tests (Alcohol Use Disorders Identification Test—Consumption [AUDIT-C] and its binge-related question [AUDIT-3]) predict ART nonadherence. Twenty-seven percent of the sample (n = 308) were positive on the AUDIT-C and 34% were positive on the AUDIT-3. In multivariate analyses, AUDIT-C–positive status predicted ART nonadherence after controlling for race, age, conscientiousness, and self-efficacy (P = .036). Although AUDIT-3–positive status was associated with ART nonadherence in unadjusted analyses, this relationship was not maintained in the final multivariate model. The AUDIT-C shows potential as an indirect screening tool for both at-risk drinking and ART nonadherence, underscoring the relationship between alcohol and chronic disease management.
CookR L, SereikaS M, HuntS C, WoodwardW C, ErlenJ A and ConigliaroJ. 2001. Problem drinking and medication adherence among persons with HIV infection. J Gen Intern Med., 16: 83–88.
2.
ConigliaroJ, GordonA J, McGinnisK A, RabeneckL and JusticeA C. 2003. How harmful is hazardous alcohol use and abuse in HIV infection: do health care providers know who is at risk?. J Acquir Immune Defic Syndr., 33: 521–525.
3.
BushK, KivlahanD R, McDonellM B, FihnS D and BradleyK A. 1998. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Arch Intern Med., 158: 1789–1795.
4.
BaborT F, Higgins-BiddleJ C, SaundersJ B and MonteiroM G. 2001. Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care, 2nd ed., Geneva: World Health Organization.
5.
BradleyK A, DeBenedettiA F, VolkR J, WilliamsE C, FrankD and KivlahanD R. 2007. AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res., 31: 1208–1217.
6.
SmithP C, SchmidtS M, Allensworth-DaviesD and SaitzR. 2009. Primary care validation of a single-question alcohol screening test. J Gen Intern Med., 24: 783–788.
7.
BradleyK A, KivlahanD R and WilliamsE C. 2009. Brief approaches to alcohol screening: practical alternatives for primary care. J Gen Intern Med., 24: 881–883.
8.
AuD H, KivlahanD R, BrysonC L, BloughD and BradleyK A. 2007. Alcohol screening scores and risk of hospitalizations for GI conditions in men. Alcohol Clin Exp Res., 31: 443–451.
9.
BradleyK A, RubinskyA DSunH. 2010. Alcohol screening and risk of postoperative complications in male VA patients undergoing major non-cardiac surgery. J Gen Int Med., 26: 162–169.
10.
BradleyK A, MaynardC, KivlahanD R, McDonellM B and FihnS D. 2001. The relationship between alcohol screening questionnaires and mortality among male veteran outpatients. J Stud Alcohol., 62: 826–833.
11.
KinderL S, BrysonC L, SunH, WilliamsE C and BradleyK A. 2009. Alcohol screening scores and all-cause mortality in male Veterans Affairs patients. J Stud Alcohol Drugs., 70: 253–260.
12.
BridevauxI P, BradleyK A, BrysonC L, McDonellM B and FihnS D. 2004. Alcohol screening results in elderly male veterans: association with health status and mortality. J Am Geriatr Soc., 52: 1510–1517.
13.
BrysonC L, AuD H, SunH, WilliamsE C, KivlahanD R and BradleyK A. 2008. Alcohol screening scores and medication nonadherence. Ann Intern Med., 149: 795–804.
14.
PearsonC R, SimoniJ M, HoffP, KurthA E and MartinD P. 2007. Assessing antiretroviral adherence via electronic drug monitoring and self-report: an examination of key methodological issues. AIDS Behav., 11: 161–173.
15.
AmmassariA, TrottaM PMurriR. 2002. Correlates and predictors of adherence to highly active antiretroviral therapy: overview of published literature. J Acquir Immune Defic Syndr., 31(S3): S123–S127.
16.
CatzS L, KellyJ A, BogartL M, BenotschE G and McAuliffeT L. 2000. Patterns, correlates, and barriers to medication adherence among persons prescribed new treatments for HIV disease. Health Psychol., 19: 124–133.
17.
ChanderG, HimelhochS and MooreR D. 2006. Substance abuse and psychiatric disorders in HIV-positive patients: epidemiology and impact on antiretroviral therapy. Drugs., 66: 769–789.
18.
CruessD G, MinorS, AntoniM H and MillonT. 2007. Utility of the Millon Behavioral Medicine Diagnostic (MBMD) to predict adherence to highly active antiretroviral therapy (HAART) medication regimens among HIV-positive men and women. J Pers Assess., 89: 277–290.
19.
ErlenJ A and SereikaS M. 2006. Fidelity to a 12-week structured medication adherence intervention in patients with HIV. Nurs Res., 55(2 Suppl): S17–S22.
20.
ReinertD F and AllenJ P. 2007. The Alcohol Use Disorders Identification Test: an update of research findings. Alcohol Clin Exp Res., 31: 185–199.
21.
GordonA J, MaistoS AMcNeilM. 2001. Three questions can detect hazardous drinkers. J Fam Pract., 50: 313–320.
22.
ErlenJ A, ChE S, KimK H, CaruthersD and SereikaS M. 2010. The HIV medication taking self-efficacy scale: psycometric evaluation. J Adv Nurs., 66: 2560–2572.
23.
BeckA, SteerR A and BrownG K. 1996. BDI-II Manual, San Antonio, TX: The Psychological Corporation, Harcourt Brace & Company.
24.
CostaP and McCraeR R. 1992. Revised NEO Personality Inventory (NEO-PI-R) and NEO Five-Factor Inventory (NEO-FFI): Professional Manual, Odessa, FL: Psychological Assessment Resources.
25.
CohenS, MermelsteinR, KamarckT, HobermanH, Sarason IG and Sarason BR. 1985. “Measuring the functional components of social support”. In Social Support: Theory, Research and Applications, 73–94. The Hague: Martinus Nijhoff.
26.
BraithwaiteR S, McGinnisK AConigliaroJ. 2005. A temporal and dose-response association between alcohol consumption and medication adherence among veterans in care. Alcohol Clin Exp Res., 29: 1190–1197.
27.
ChanderG, LauB and MooreR D. 2006. Hazardous alcohol use: a risk factor for non-adherence and lack of suppression in HIV infection. J Acquir Immune Defic Syndr., 43: 411–417.
28.
TuckerJ S, BurnamM A, SherbourneC D, KungF Y and GiffordA L. 2003. Substance use and mental health correlates of nonadherence to antiretroviral medications in a sample of patients with human immunodeficiency virus infection. Am J Med., 114: 573–580.
29.
HopwoodC J, MoreyL CSkodolA E. 2007. Five-factor model personality traits associated with alcohol-related diagnoses in a clinical sample. J Stud Alcohol Drugs., 68: 455–460.
30.
O'CleirighC, IronsonG, WeissA and CostaP TJr.2007. Conscientiousness predicts disease progression (CD4 number and viral load) in people living with HIV. Health Psychol., 26: 473–480.
31.
IronsonG H, O'CleirighC, WeissA, SchneidermanN and CostaP TJr.2008. Personality and HIV disease progression: role of NEO-PI-R openness, extraversion, and profiles of engagement. Psychosom Med., 70: 245–253.
32.
HinkinC H, HardyD JMasonK I. 2004. Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse. AIDS., 18(Suppl 1): S19–S25.
33.
PatersonD L, SwindellsSMohrJ. 2000. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med., 133: 21–30.
34.
GolinC E, LiuHHaysR D. 2002. A prospective study of predictors of adherence to combination antiretroviral medication. J Gen Intern Med., 17: 756–765.
35.
GalvanF H, BingE GFleishmanJ A. 2002. The prevalence of alcohol consumption and heavy drinking among people with HIV in the United States: results from the HIV Cost and Services Utilization Study. J Stud Alcohol., 63: 179–186.
