Alcohol use, abuse, and dependence are prevalent among HIV-infected individuals, and are associated with delayed initiation of and adherence to antiretroviral therapy (ART), and with HIV disease transmission and progression. Prior research on the intersection of alcohol and HIV has been conducted in relatively small samples or in select groups whose results may not be generalizable to the overall population of HIV-infected individuals. The Alcohol Research Consortium in HIV - Epidemiology Research Arm (ARCH-ERA), will address this deficit in our knowledge by studying the short and long-term effects of alcohol on clinical outcomes among persons with HIV. We will accomplish this by elucidating the burden of alcohol use, its effect on HIV disease progression, and its impact on engagement in clinical care, health care utilization and costs. ARCH-ERA will be based in the CFAR Network of Integrated Clinical Systems (CNICS), a national network of 8 HIV clinical care sites and over 20,000 HIV-infected men and women receiving HIV care. CNICS is the ideal setting for ARCH-ERA because of its collection of comprehensive patient care and clinical outcomes data that is linked to patient-provided information on alcohol use, substance use, medical and psychiatric morbidities, adherence, HIV transmission risk behaviors, and quality of life (QOL). Capitalizing on the resources and infrastructure of CNICS, we propose the following aims: To determine the burden of hazardous alcohol consumption to HIV infected individuals;to determine the impact of different levels and pattern of alcohol use on HIV disease progression over time, and to evaluate the impact of alcohol use on HIV health care utilization and costs of care. Particular attention will be paid to the roles of sex/gender, illicit drug use, and mental health symptoms in the relationship between alcohol and HIV.

Public Health Relevance

Alcohol use, abuse and dependence are prevalent among HlV-infected individuals and are associated with poor outcomes, more severe psychiatric and medical comorbidities, and high individual and social costs. Elucidating how alcohol affects HIV in the short- and long-term, and the associated economic costs, will inform interventions to improve HIV care, reduce alcohol use, and improve quality of life and survival among persons with HIV.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Research Project--Cooperative Agreements (U01)
Project #
Application #
Study Section
Special Emphasis Panel (ZAA1)
Program Officer
Roach, Deidra
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Washington
Internal Medicine/Medicine
Schools of Medicine
United States
Zip Code
Fredericksen, Rob J; Mayer, Kenneth H; Gibbons, Laura E et al. (2018) Development and Content Validation of a Patient-Reported Sexual Risk Measure for Use in Primary Care. J Gen Intern Med 33:1661-1668
Lau, Bryan; Lesko, Catherine (2018) Missingness in the Setting of Competing Risks: from missing values to missing potential outcomes. Curr Epidemiol Rep 5:153-159
Yang, Cui; DeBartolo, Peter; McCaul, Mary E et al. (2018) The role of personal and household members' substance use in health-related quality of life in women living with HIV/AIDS. AIDS Care 30:473-479
Bilal, Usama; McCaul, Mary E; Crane, Heidi M et al. (2018) Predictors of Longitudinal Trajectories of Alcohol Consumption in People with HIV. Alcohol Clin Exp Res 42:561-570
Lee, Kristen; Hutton, Heidi E; Lesko, Catherine R et al. (2018) Associations of Drug Use, Violence, and Depressive Symptoms with Sexual Risk Behaviors Among Women with Alcohol Misuse. Womens Health Issues 28:367-374
Lesko, Catherine R; Edwards, Jessie K; Cole, Stephen R et al. (2018) When to Censor? Am J Epidemiol 187:623-632
Merlin, Jessica S; Long, Dustin; Becker, William C et al. (2018) Brief Report: The Association of Chronic Pain and Long-Term Opioid Therapy With HIV Treatment Outcomes. J Acquir Immune Defic Syndr 79:77-82
Calkins, Keri L; Canan, Chelsea E; Moore, Richard D et al. (2018) An application of restricted mean survival time in a competing risks setting: comparing time to ART initiation by injection drug use. BMC Med Res Methodol 18:27
Lesko, Catherine R; Keil, Alexander P; Moore, Richard D et al. (2018) Measurement of Current Substance Use in a Cohort of HIV-Infected Persons in Continuity HIV Care, 2007-2015. Am J Epidemiol 187:1970-1979
Lesko, Catherine R; Jacobson, Lisa P; Althoff, Keri N et al. (2018) Collaborative, pooled and harmonized study designs for epidemiologic research: challenges and opportunities. Int J Epidemiol 47:654-668

Showing the most recent 10 out of 45 publications