Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jul 21, 2020
Date Accepted: Sep 16, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Event-level association between daily alcohol use and same-day non-adherence to antiretroviral therapy among young men who have sex with men and trans women living with HIV
ABSTRACT
Background:
Young trans women (TW) and men who have sex with men (MSM) are disproportionately impacted by HIV. Optimizing adherence to antiretroviral therapy (ART) is one mechanism by which public health experts aim to achieve favorable HIV health outcomes while reducing disease transmission. However, alcohol use is prevalent among young TW and MSM and threatens optimal adherence. In addition, the daily variations in alcohol and ART use, and how they relate to one another, are poorly understood, warranting more appropriate methodological approaches such as analysis of ecological momentary assessment (EMA) data.
Objective:
The aim of this analysis is to characterize the association between daily alcohol use and same-day ART non-adherence captured by an EMA study of young MSM and TW living with HIV in San Francisco.
Methods:
Young MSM and TW enrolled in the Health eNav study were included in the analytic sample (n=113). Alcohol and ART use were collected by daily EMA surveys administered via text messaging and were analyzed over 30 days of follow-up. A multivariable mixed effects logistic regression model adjusting for baseline socio-demographics was specified to investigate whether daily alcohol use was associated with same-day ART non-use.
Results:
Daily alcohol use was associated with 1.89 (95% CI = 1.14 – 3.15) times the adjusted odds of same-day ART non-use for each participant.
Conclusions:
Results are consistent with other analyses of daily alcohol and ART use, and underscore the importance of individually-targeted interventions that are sensitive to each participant’s dynamic risk environment.
Citation
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