Alcohol use disorder may be associated with human immunodeficiency virus

Alcohol Use Disorder Diagnoses Among Individuals Who Take HIV Preexposure Prophylaxis

1. In this cohort of individuals taking preexposure prophylaxis (PrEP), there was an increase in the development of an alcohol use disorder (AUD) within 6 months of initiation.  

Evidence Rating Level: 2 (Good) 

One way to prevent the human immunodeficiency virus (HIV) epidemic is the use of preexposure prophylaxis (PrEP). There are several important stages of taking PrEP, which may be affected by outside factors such as alcohol use. The existing literature shows mixed findings regarding PrEP adherence and continuation in association with alcohol use. To build on this lacking literature, this retrospective cohort study was conducted to estimate the prevalence of alcohol use disorder (AUD) diagnoses before and after PrEP initiation. Individuals between the ages of 16 and 64 at the initiation time were included in the study. The primary outcome of this study was AUD diagnosis. Based on this, the cohort was divided into three groups: AUD diagnosis before initiation, AUD diagnosis after initiation, and individuals without AUD diagnoses at baseline or during the follow-up periods. After eligibility criteria were met, a total of 43,913 individuals taking PrEP were included (mean [SD] age 35.80 [10.94] years). Among them, 38,050 (86.65%) received TDF/FTC, and 5863 (13.35%) received TAF/FTC. After six months of PrEP initiation, 6274 (14.29%) individuals had a diagnosis of AUD, with 1245 (2.84%) receiving their diagnosis at baseline, and 5029 (11.45%) receiving their diagnosis after starting PrEP. Whether AUD diagnosis was received before or after initiation of PrEP, the associated sociodemographic and clinical factors remained similar. Specifically, male sex assigned at birth (before: adjusted odds ratio [aOR], aOR, 0.62; 95% CI, 0.52-0.73; after: aOR, 0.81; 95% CI 0.52-0.73; after: aOR, 0.81; 95% CI, 0.73-0.90) and mental health conditions such as depression (before: aOR, 2.36; 95% CI, 2.78-3.84; after: aOR, 3.17; 95% CI, 2.88-3.49). Overall, in this cohort study of individuals taking PrEP, almost 15% had an AUD diagnosis within 6 months of initiation. 

Image: PD

©2025 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.