Alcohol Use and Health Outcomes in HIV Populations

Alcohol consumption remains a pervasive concern among people living with HIV, intersecting with clinical, behavioural and social determinants of health. Patterns range from low‐level use to hazardous and binge drinking, each carrying distinct risks. Excessive alcohol intake undermines adherence to antiretroviral therapy (ART), contributing to suboptimal viral suppression and increased HIV transmission potential. Biologically, alcohol exacerbates liver injury, accelerates comorbid hepatitis and heightens systemic inflammation, which may impair immune recovery. Psychosocially, it compounds mental health disorders, destabilises housing and social support, and interacts with other substance use, creating syndemic burdens. Globally, regions with high HIV prevalence face compounded challenges as alcohol use amplifies morbidity and mortality. In clinical settings, targeted screening and integrated care models aim to identify unhealthy drinking, deliver brief interventions and tailor stepped treatment to reduce alcohol‐related harm and improve HIV-related outcomes. Emerging evidence underscores the necessity of multidisciplinary approaches that address alcohol use alongside mental health and social needs, reinforcing the principle that optimising HIV care requires addressing alcohol as a key modifiable risk factor.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Alcohol Use and Health Outcomes in HIV Populations publication trend

The graph below shows the total number of articles in alcohol use and health outcomes in hiv populations across all publications each year (not limited to Nature Index journals).

Technical terms

Antiretroviral therapy (ART): Combination of medications that suppress HIV replication and maintain immune function.

Binge drinking: Consumption of a large quantity of alcohol in a short period, often defined as ≥4 drinks for women or ≥5 drinks for men per occasion.

Durable viral suppression: Sustained reduction of HIV RNA below a defined threshold, typically <200 copies/mL, over multiple clinical assessments.

Integrated stepped care: A hierarchical treatment approach starting with low-intensity interventions and escalating to specialised therapies based on patient response.

Ecological momentary assessment (EMA): Repeated real-time data collection method capturing behaviours and experiences in naturalistic settings.

References

1. Event-Level Association Between Daily Alcohol Use and Same-Day Nonadherence to Antiretroviral Therapy Among Young Men Who Have Sex With Men and Trans Women Living With HIV: Intensive Longitudinal Study. JMIR mHealth and uHealth (2020).
2. The Impact of Binge Drinking on Mortality and Liver Disease in the Swiss HIV Cohort Study. Journal of Clinical Medicine (2021).
3. Integrated stepped alcohol treatment for patients with HIV and at-risk alcohol use: a randomized trial. Addiction Science & Clinical Practice (2020).