Problem Drinking and Medication Adherence Among Persons with HIV Infection


  • Presented in part at the 22nd annual meeting of the Society of General Internal Medicine, San Francisco, Calif, May 1999.

Address correspondence and reprint requests to Dr. Cook: University of Pittsburgh School of Medicine, E820 UPMC Montefiore, 200 Lothrop St., Pittsburgh PA 15213 (e-mail:


OBJECTIVE: To examine the relation between problem drinking and medication adherence among persons with HIV infection.

DESIGN: Cross-sectional survey.

SETTING/PARTICIPANTS: Two hundred twelve persons with HIV infection who visited 2 outpatient clinics between December 1997 and February 1998.

MEASUREMENTS AND MAIN RESULTS: Nineteen percent of subjects reported problem drinking during the previous month, 14% missed at least 1 dose of medication within the previous 24 hours, and 30% did not take their medications as scheduled during the previous week. Problem drinkers were slightly more likely to report a missed dose (17% vs 12 %, P = .38) and significantly more likely to report taking medicines off schedule (45% vs 26%, P = .02). Among drinking subtypes, taking medications off schedule was significantly associated with both heavy drinking (high quantity/frequency) (adjusted odds ratio [OR], 4.70; 95% confidence interval [95% CI], 1.49 to 14.84; P < .05) and hazardous drinking (adjusted OR, 2.64; 95% CI, 1.07 to 6.53; P < .05). Problem drinkers were more likely to report missing medications because of forgetting (48% vs 35%, P = .10), running out of medications (15% vs 8%, P = .16), and consuming alcohol or drugs (26 % vs 3 %, P < .001).

CONCLUSION: Problem drinking is associated with decreased medication adherence, particularly with taking medications off schedule during the previous week. Clinicians should assess for alcohol problems, link alcohol use severity to potential adherence problems, and monitor outcomes in both alcohol consumption and medication adherence.