Evidence Synthesis and Tables

Article Number

Author and Date

Evidence Type

Sample, Sample Size, Setting

Findings That Help Answer the EBP Question

Observable Measures

Limitations

Evidence Level, Quality

DOI 10.1186/s13722-017-0090-0

Cook, R. L., Zhou, Z., Kelso-Chichetto, N. E., Janelle, J., Morano, J. P., Somboonwit, C., ... & Bryant, K. (2017). Alcohol consumption patterns and HIV viral suppression among persons receiving HIV care in Florida: an observational study. Addiction science & clinical practice, 12(1), 22.Retrieved from https://ascpjournal.biomedcentral.com/track/pdf/10.1186/s13722-017-0090-0.pdf

Quantitative

Evidence.

The participants of the study were recruited from community setting clinics across Florida and others from a collaborative network of health departments across the state.

There were 619 participants, 63 % of whom were male and 37 % were female. In terms of race, 22% were non-Hispanic whites, 56 % were non0hisanic blacks, 16 % were Hispanic, and 4 % represented others. The researchers also analyzed the participants in terms of the level of education in four categories: less than high school (33%), high school or equivalent (31%), and above high school (36%). 84 % of the participants experienced homelessness, while 16 % did not (Cook et al., 2017).

The research revealed that heavy and binge drinking was common among participants with less than high school education, smokers and illicit drugs users, homeless people, and participants with anxiety and depression.

The rate of adherence reduces with an increase in the rate of alcohol consumption. Optimal adherence was reported by 80% of non-drinkers, 68 % of low-level drinkers, 58 % of binge drinkers, and 51% of heavy drinkers. When compared to abstinence, heavy drinking

There is a direct effect between heavy drinking and suboptimal ART suppression, and an indirect, smaller, but a significant effect that is mediated via poor ART adherence.

Generally, the findings suggest that the relationship between heavy drinking and suboptimal HIV viral suppression could be due to other factors such as the effects of alcohol on the immune system, behavior, such as persistence on therapy and engagement in care.

Like other studies, this study revealed that the rate and not patterns of alcohol drinking leads to poor HIV viral suppression. An increase in the consumption of alcohol leads to poor viral suppression and vice versa.

Therefore, researchers recommend the implementation of alcohol consumption strategies in HIV clinical and public health routine. The findings also reinforce the benefits of screening and brief intervention for alcohol-related problems in HIV care settings (Cook et al., 2017). A further proposal is to identify drinkers who are in dire need of intervention and come up with the most effective strategies.

Through the anonymous self-reported questionnaire, the participants answered questions that measured four observable characteristics: Alcohol consumption,

Covariates, Antiretroviral adherence, and viral suppression.

Self-reported adherence may over-estimate adherence, especially from dishonest participants. Although it was anonymous, it is normal for a participant to overestimate adherence.

Another limitation is that the sampling was based on convenience and may not represent the entire population of people living with HIV/AIDS in Florida (Cook et al., 2017). The researchers based on people who were under care for the previous one year only.

The sample was lower compared to other studies involving people living with HIV/AIDS, and since the number of questions was limited, there is a likelihood of an underestimation of the actual consumption. However, the researcher tried to address these limitations by obtaining information on HIV viral suppression from the state HIV surveillance. The representation of diverse demographic groups could also address the sample limitations.

Level-III

Quality-Good.

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