Dataset Information

Gender and alcohol use: influences on HIV care continuum in a national cohort of patients with HIV.

ABSTRACT: OBJECTIVES:To investigate whether gender is associated with three recommended stages of the HIV care continuum and whether gender modifies known associations between level of alcohol use and HIV care among US veterans. DESIGN:Retrospective cohort. METHODS:Veterans Aging Cohort Study data were used to identify Veterans Health Administration (VA) patients with HIV and AUDIT-C alcohol screening from 1 February 2008 to 30 September 2014. Modified Poisson regression models estimated the relative risk and predicted prevalences of engagement in HIV care (documented CD4?cells/?l or viral load copies/ml lab values), ART treatment (at least one prescription), and viral suppression (HIV RNA <500?copies/ml) in the year following AUDIT-C (1) for women compared to men, and (2) for each level of alcohol use compared to nondrinking among women and among men. A multiplicative interaction between gender and alcohol use was tested. RESULTS:Among 33?224 patients, women (n?=?971) were less likely than men (n?=?32?253) to receive HIV care (P values <0.001). Respective predicted prevalences for women and men were 71.9% (95% CI 69.1-74.7%) and 77.9% (77.5-78.4%) for engagement, 60.0% (57.0-73.14%) and 73.8% (73.4-74.3%) for ART treatment, and 46.4% (43.3-49.6%) and 55.8% (55.3-56.3%) for viral suppression. Although the interaction between gender and alcohol use was not statistically significant, stratified analyses suggested worse outcomes for women than men at higher levels of alcohol use. CONCLUSION:In this large national cohort, women were less likely than men to be engaged in HIV medical care, prescribed ART, and virally suppressed. Interventions to improve HIV care for women are needed at all levels of alcohol use.

SUBMITTER: Matson TE

PROVIDER: S-EPMC6136970 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Gender and alcohol use: influences on HIV care continuum in a national cohort of patients with HIV.

Matson Theresa E TE McGinnis Kathleen A KA Rubinsky Anna D AD Frost Madeline C MC Czarnogorski Maggie M Bryant Kendall J KJ Edelman E Jennifer EJ Satre Derek D DD Catz Sheryl L SL Bensley Kara M KM Fiellin David A DA Justice Amy C AC Williams Emily C EC

AIDS (London, England) 20180901 15

<h4>Objectives</h4>To investigate whether gender is associated with three recommended stages of the HIV care continuum and whether gender modifies known associations between level of alcohol use and HIV care among US veterans.<h4>Design</h4>Retrospective cohort.<h4>Methods</h4>Veterans Aging Cohort Study data were used to identify Veterans Health Administration (VA) patients with HIV and AUDIT-C alcohol screening from 1 February 2008 to 30 September 2014. Modified Poisson regression models estim ...[more]

PMID: 30005010

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Project description:This study examines Korean college students' rates and the severity of various negative consequences resulting from the frequency and quantity of alcohol consumption and the unique factors that are affecting this problem in the Korean context in comparison to other countries. It assesses how much gender, age and other associated respondent characteristics mediate alcohol use and the resulting negative consequences among the population. A stratified representative sample of 4803 valid student respondents attending 82 colleges participated in the alcohol consumption survey, of which 95% reported drinking in past 12 months. Drinking is measured by the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) screening tool. Based on this test, composite scores for each participant were computed and students were grouped into four risk groups: (a) nondrinkers, (b) light drinkers, (c) moderate drinkers and (d) heavy drinkers. Outcome measures include 21 validated items evaluating self-reported alcohol-related negative consequences. Rates of negative consequences are reported for each drinking risk group stratified by gender. Descriptive statistics, stepwise regression, multivariate linear regression and MANOVA tests were used to analyze the data. The study found that female respondents in the sample who consumed alcohol in the past 12 months drank 11.5 percent less than males (AUDIT-C score ? = 6.0 and 6.7, respectively), and there was a greater proportion of females (5.1 percent) who were nondrinkers than males (4.6 percent). Yet, when females drank, they experienced 11.8 percent more negative consequences on average than males (? = 1.9 and 1.7, respectively). The study attempts to explain this apparent contradiction. The self-reported rates for many individual negative consequences also varied discernibly by gender. The study concludes with suggestions for how alcohol prevention on Korean college campuses would benefit from targeting females and males differently.

Dataset Information

Gender and alcohol use: influences on HIV care continuum in a national cohort of patients with HIV.

Publications

Gender and alcohol use: influences on HIV care continuum in a national cohort of patients with HIV.

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