Vagenas, P., Azar, M.M., Copenhaver, M.M., et al. Current HIV/AIDS Reports (September 2015), e-publication ahead of print.
The authors reviewed 53 papers published between 2010 and 2015 on the impact of alcohol use and related disorders (AUDs) upon each stage of the HIV treatment cascade, given recommendations to provide antiretroviral therapy (ART) earlier in the course of their disease. Most of the studies (77%) found that alcohol use negatively affected one or more stages of the HIV care continuum. Two studies that addressed more than one step in the cascade found a negative link between alcohol use and at least one stage of the cascade. One study found a negative association between alcohol use and a specific stage of the HIV cascade, ART adherence—demonstrating lower adherence with greater alcohol use. Negative links between alcohol use and specific steps in the HIV treatment cascade were seen in countries with both low and high levels of per capita alcohol use. The authors concluded that the best approach for improving HIV treatment outcomes in HIV-positive persons with AUDs will be to ensure high-quality integration of prevention and treatment services, including alcohol treatment, within clinical care settings.